Small and medium enterprises (SMEs) are carriers of the economic development on local, regional, and national level. With high levels of flexibility, agility and adaptability, small and medium enterprises have the ability to transform and embrace new emerging technologies and opportunities. In the Industry 4.0 world, characterized by the intensive development and integration of digital solutions into all levels of operations, SMEs are among early adopters of such solutions. The purpose of the paper is to examine how small and medium enterprises in the Middle East are increasing their competitiveness, using innovative digital and e-business solutions as key transformative tools. Within the research, a systematic review of support ecosystem for development of the sector in the Middle East has been performed. Based on the systematic review and literature findings, the 5I framework, consisting of internationalization, innovation, integration, implementation, and intensifying, has been suggested as the model for transformative development of small and medium enterprises. In the future research, it is possible to examine how fast-growing economies that create supportive environment for the development of small and medium enterprises, simultaneously recognizing digital and e-business solutions as important pillar of increasing competitiveness and innovativeness, might benefit from successful implementation of 5I framework for successful global transformation.