We use multiple case study methodology to examine firm-level antecedents and consequences of foreign CEO hiring decisions in Japan. We also examine foreign CEO attributes and the strategic initiatives launched by the foreign CEOs to understand differences in consequences. Study findings suggest that foreign CEOs in Japan are not all "complete outsiders" to the organization and the nation—most Japanese firms prefer to hire a CEO with prior work experience in Japan. Overall, foreign-born CEOs are successful in Japan only if they have a vision and the executive clout to transform the organization.