This document analyzes data from a global survey of over 10,000 business respondents and 5,600 business owners across 78 countries to assess the state of small and medium-sized entrepreneurial businesses worldwide. Some of the key findings include: SMEs contribute significantly to economic output and employment in many regions, including 50% of GDP and jobs in Western economies and 59% of various economic indicators in China. However, many entrepreneurs report difficulties accessing credit, increasing regulations, late payments hurting cash flow, and rising stress levels. To better support SMEs, the majority of entrepreneurs believe governments and banks should increase lending, introduce penalties for late payments, and establish venture capital funds.