Extant literature remains inconclusive with regard to optimal structural designs for sustaining effective knowledge flows, boosting innovativeness, and achieving superior performance in organizations. We contribute to the ongoing debate on formal, informal, and ambidextrous configurations in the specific context of small high-tech innovators. Adopting an inductive approach to theory building, we explore the factors that account for the variation in knowledge-focused designs across sample firms. In our study, innovative ventures rely on pure formal and informal organizational designs but also attempt to mix both, suggesting that gains from ambidexterity are not ubiquitous. Our analysis unveils that the pursuit of a given structural configuration results from a set of operating contingencies and a deliberate managerial effort to align firm idiosyncrasies with desired strategic outcomes. We advance a grounded theory of knowledge-focused organizational design in small high-tech innovators and formulate propositions that may be tested in future inquiries in the field.