With regard to the management innovation, there is a strong tendency among Korean academic community to focus of the case of large companies because of that they are well-known to the readers and play an important role in creating best practices. However, small and medium companies take an important place in Korean economy: they represent more than 99% in the total number of establishments and 87% in total number of employees in Korea. In spite of the importance of the innovation in small and medium companies, it is generally accepted that they fails in their innovation due to the lack of CEO’s commitment, man power and competency. In fact, they are relatively in a disadvantage compared to the large companies in all aspects.The management innovation need not to be done in large companies. Small and medium companies might need it more to survive the cut-throat competition. Our case study aims to fill the gap between the importance of SMEs and lack of researches in analyzing a very small dental clinic. Through our study, we have kept in mind such a research question: what are the similar and different characteristics of the management between small and large companies.Our case shows that a small company too needs a strong innovation to overcome the competition, and it can succeed in its innovation in spite of the financial and human resource constraints. And our study offers an important lesson that in small company also, the commitment of CEO play a critical role in the success of innovation. On the other hand, a small company is shown to have some advantage in pursuing innovation: when the CEO strongly commits himself, we can observe more close and active communication and spontaneous participation in the management innovation.