Small and Medium Enterprises (SMEs) play a pivotal role in an economy but in a developing country like Pakistan face various critical issues that hold back its potential contribution to the prosperity. An investigation is carried out to find out the issues faced by manufacturing SMEs in Khyber Pakhtunkhwa (KP), Pakistan. Using multi-case approach, data for the research has been gathered through sixty semi-structured interviews from the Chief Executive Officers (CEO) and Senior Managers. The general issues raised include extended and unscheduled power failure, poor support from government, stringent government regulations, higher business cost and narrow profit margin, corruption, political influence, and seasonal effects. The research serves a great deal of value for the investors, government, and chambers of commerce to take corrective action in time and to enhance the potential contribution of SMEs.