Members of frontline low-status occupational groups often have access to a vast pool of knowledge, expertise, and experience that may be valuable for organizations. However, previous research has shown that members of these occupational groups are often reluctant to exhibit voice behavior due to their low position in the organizational hierarchy and perceived status differences. Drawing on in-depth interviews with auxiliary nurses (ANs) who participated in a development trajectory, as well as with their colleagues and supervisors, we demonstrate how members of this low-status occupational group develop voice behavior. Our findings show how acquiring three different types of knowledge and acting on this knowledge can lead to forming new and different types of relationships with members of higher status occupational groups in the organization. Subsequently, these relational changes enhanced voice behavior, as the ANs under study became more skillful in navigating the organization and felt better equipped to share their ideas, concerns, and perspective. We contribute to the literature on voice behavior by members of low-status occupational groups by moving beyond the findings of previous studies that have shown that low-status employees are unlikely to exhibit voice behavior. We detail how the development of knowledge, as well as relationships between different occupational groups, is crucial for the enhancement of voice behavior that transcends hierarchical levels. Moreover, we add to the literature on upward influence of subordinates by showing how such voice allows subordinates to exert upward influence in their organizations and initiate change that benefits their own occupational group.