Social enterprises (SEs) operate as mission-driven ventures that integrate social goals with entrepreneurial means to address systemic inequalities and service gaps. Within the healthcare sector in Malaysia, these enterprises play an increasingly vital role by offering accessible, community-embedded, and innovative services in contexts where public and private systems fall short. This chapter examines two dominant modes of healthcare social enterprises: Mode 1 (Grassroots SEs), driven by civic actors and local needs, and Mode 2 (Research Spin-off SEs), shaped by public research and development (R&D) institutions and the pursuit of knowledge valorisation. Drawing from in-depth case studies, the chapter analyses how these enterprises mobilise resources, forge partnerships, and configure their business models to navigate operational, regulatory, and legitimacy challenges. While grassroots SEs prioritise relational trust, frugal innovation, and voluntary engagement, spin-off SEs leverage scientific expertise, state-linked infrastructure, and hybrid funding to deliver targeted solutions. By comparing their institutional logics and innovation pathways, the chapter reveals how each mode contributes to inclusive and sustainable healthcare delivery. It also offers policy insights to better recognise, support, and scale these enterprises in alignment with national development goals and local health equity agendas.