This study aimed to identify and explain the factors affecting organizational innovation in pharmaceutical companies listed on the Tehran Stock Exchange with a focus on the economic leap approach. The present study was applied in terms of purpose and qualitative in nature using thematic analysis, complemented by questionnaire data in the final stage. The research population consisted of senior managers, chief executive officers, and research and development managers of pharmaceutical companies listed on the Tehran Stock Exchange. Qualitative data were collected through 10 semi-structured interviews, and an online Porsline questionnaire was distributed among 25 pharmaceutical industry managers to validate and prioritize the findings. Data analysis was conducted through open, axial, and selective coding as well as thematic analysis. Questionnaire data were analyzed using descriptive statistics and factor ranking procedures. The findings revealed that organizational innovation in the Iranian pharmaceutical industry is influenced by seven major factors, including human capital, absorptive capacity of knowledge and technology, innovation-oriented organizational culture, investment in research and development, flexible organizational structure, external collaborations, and incremental low-cost innovation. Among these factors, human capital achieved the highest priority and was identified as the primary driver of organizational innovation. The results also demonstrated that absorptive capacity plays a critical role in exploiting technological opportunities and localizing external knowledge. Furthermore, a learning-oriented organizational culture characterized by adaptability, risk tolerance, and acceptance of failure was recognized as an essential platform for innovation development. The findings indicated that Iranian pharmaceutical companies tend to prioritize incremental and low-cost innovations and adopt a cautious approach toward external collaborations due to institutional and economic constraints. The results demonstrated that organizational innovation in Iranian pharmaceutical companies is shaped by the simultaneous interaction of human, technological, structural, and environmental factors. Achieving innovation success requires strengthening human capital, developing absorptive capacity, fostering an innovation-oriented culture, and strategically utilizing technological opportunities and external collaborations.