The study examined the mediating role of top management leadership between institutional pressures and sustainable supply chain management practices. Specifically, it examined how top management leadership mediates the relationship between institutional pressures and sustainable procurement, sustainable manufacturing operations and reverse logistics. It also assessed how institutional pressures and top management leadership influence sustainable supply chain management practices. The research was quantitative, with data gathered from 386 medium and large-sized manufacturing facilities located in the Greater Accra, Ashanti, and Western regions of Ghana. Structural equation modelling was used as the analytical tool. The study's findings show that institutional pressures significantly affect the components of sustainable supply chain management. It also demonstrated that top management leadership significantly affects sustainable supply chain management aspects except for sustainable manufacturing operations. Furthermore, the research findings indicate that, except for sustainable manufacturing operations, the relationship between institutional pressures and other aspects of sustainable supply chain management is significantly mediated by top management leadership.