The purpose of this chapter is to provide an insight on the status of quality management practices in small and medium-sized enterprises (SMEs) of South India. A survey-based approach was adopted to understand the established quality management practices in the SMEs. A short survey instrument was designed by reviewing the literature on quality management initiatives in SMEs. Sample of 270 manufacturing SMEs across Southern India was selected through stratified random sampling technique. Projects with small teams, management commitment and involvement, communication, and culture change have high influence as success factors in implementing quality initiatives. Overall equipment effectiveness, root cause analysis, bottleneck analysis, and PDCA are often used tools and techniques by the organizations. High cost of training and limited knowledge were the reasons cited for not implementing quality initiatives. The study is an attempt to understand the quality management practices application in SMEs from a specific geographic location. The strength lies in bringing a different perspective from the present studies, whereas specific context of the study limits its generalizability. The findings of this chapter will help the industry to identify current quality management practices in SMEs to focus on improving their performance.