Recently, small and medium enterprises in Thai Nguyen have developed in both quantity and qualities, making tremendous contributions to diversify types of businesses, create jobs and income for workers. In order to survive and with stand the fierce competition in the market economy, the efficiency of business operations is more important than ever. However, the business performance of SMEs fails to meet the demands of economic development in Thai Nguyen. Based on an analysis of operating efficiency of SMEs in Thai Nguyen, the authors recommend some solutions to improve this situation and thus enhance the SMEs' competitiveness again other business types in the economy.