Purpose: Business has a critical part to play in transforming the global economy and society to achieve sustainable development. Many granular sustainability accounting and management tools have been offered. To systematize these piecemeal developments, this paper aims to develop a framework for analysis of the potential role of sustainability management accounting (SMA). The key challenge addressed is how SMA could be extended to support future-oriented, long-term, pro-active management of multiple issues to contribute towards strong sustainable development at the macro-economy level. Design/methodology/approach: This conceptual paper examines SMA within a multi-level, context-action-transformation framework which can move organizations and society towards sustainability. Based on normative stakeholder theory, including concern for mainstreaming marginalized stakeholders, the paper discusses the role of SMA and how it can contribute necessary information to sustainable development of the company and beyond its boundaries. Findings: Guided by a SMA framework linking context, action and transformation and normative stakeholder theory, which considers all stakeholders, the paper shows how the present lack of progress towards macro-level sustainable development can be addressed. This requires a focus on measuring and assessing positive impacts and forward-looking, long-term and proactive management of multiple sustainability issues as typified by the Sustainable Development Goals (SDGs). Practical implications: The paper distinguishes between two aspects of SMA – a focus on reducing unsustainability and a focus on transformations towards sustainability. It is observed that there is insufficient emphasis on the latter at present if SMA is to provide comprehensive support to achieving the SDGs. A set of supportive tools is presented as a guide to practice and future developments. Originality/value: The paper considers how SMA can enable and support transformations towards sustainability at the macro- and meso-level. Different transformational challenges and opportunities are discussed. In particular, the need to balance consideration of time, proactivity and multiplicity, as highlighted in the SDGs, is identified as the central way forward for SMA.