This document discusses the need for small and medium enterprises (SMEs) to implement Lean Six Sigma (LSS) methods to improve quality, productivity, and cost competitiveness in order to meet global demand and retain customers. LSS can help SMEs eliminate waste and reduce costs through tools that optimize processes. Case studies show large companies saved over $1 billion through LSS. While total quality management and total productive maintenance may be difficult for SMEs, LSS provides similar benefits with less investment. LSS tools like value stream mapping, root cause analysis, and statistical process control can help SMEs improve processes to consistently deliver high quality products at lower costs.