Process-relational perspectives (PRP) have been put forward as a crucial contribution for conceptualizing radical transformations towards sustainability. This is because PRP conceptualize transformations as open processes. This openness is attributed, first, to processes and relations having performative power, which means that processes and relations are constitutive of elements. Second, PRP take processes and relations as continuously unfolding which means that elements taking part in transformations continuously change. Therefore, transformations are conceptualized beyond what elements are and do at a particular moment, setting PRP apart from other ways of conceptualizing transformations that don’t. This has an impact on transformative potential which for PRP is thus different (and perhaps more radical) than for the more conventional counterparts. Inquiring into the implications of tapping into this potential brings us to the topic of causation. Fostering transformation requires an understanding of the causal workings of systems. However, establishing causal links is difficult and for many, speaking of causation entails the risk of conveying a deterministic perspective inadequate for such a task. To avoid such risk, process-relational scholars urge us to rethink the concept of causation so that it can be mobilized to support a PRP on transformations. This paper takes the reader through a conceptual deep dive into process-relational understandings of transformation and causation. It encourages the reader to question conventional views of causation and ends by offering a process-relational take on theories of change (ToCs) that are often mobilized to foster transformations towards sustainability.