Knowledge sharing, if not successful, can hinder the development of small- and medium-sized firms because of loss of productivity and competitiveness. Knowledge sharing is subject to organizational and national cultural influences. Medium-sized firms often implement general knowledge-sharing models without considering cultural factors. In this qualitative, multisite, exploratory case study the influence of cultural factors on knowledge-sharing activities in medium-sized enterprises in transition economies is examined. The study is driven by the central research question: How do cultural factors influence employees' perceptions of knowledge-sharing initiatives in medium-sized enterprises in transition economies? Qualitative in-depth interviews were conducted with 20 managers working in 10 medium-sized enterprises in Albania, which is a transition economy. The six themes generated reveal the influence of cultural factors on employees' perceptions of knowledge-sharing initiatives in medium-sized enterprises in transition economies. The key findings of this study are that national culture and organizational culture influence employee behavior and participation.