This paper highlights the growing importance towards supporting Chinese Small to Medium sized Enterprises (SMEs) in adopting pro-active and collaborative behaviors that stimulate sustainability initiatives. Equating to 90% of enterprises in the country and contributing towards 60% of the nation's gross domestic product (GDP), China's SMEs are recognized for their willingness to engage in change, raising the potential for exploring and embarking on new ventures. This paper proposes that a design thinking mind-set, rooted in empathic stakeholder dialogue, conceptually supports SMEs to engage with the increasingly complex challenges that envelop China's society, culture, economy, and environment. Discussion emphasizes that proactively including and responding to the various and ambiguous needs of stakeholders leads to increased opportunity for innovation and new ways of thinking, both being vital for sustainable and responsible growth. Equally, the questions of whom to empathize with and how should SMEs empathize are postulated as roadblocks to the adoption of design thinking in SMEs. This paper proposes a model for addressing those challenges.