Organisational competitiveness hinges on the strategic integration of digital transformation (DT), emerging skills (ES), and organizational health (OH) to foster sustainable performance. Despite the pivotal role of these variables, limited research investigates their interplay in Micro, Small, and Medium Enterprises (MSMEs) in Indonesia. This study addresses this gap by empirically examining how MSMEs navigate challenges and opportunities amid the digital transformation landscape. Specifically, the research probes the intermediary function of the synergistic integration between DT and ES, influencing organisational performance (OP) moderated by OH. Utilizing a validated questionnaire, a three-month convenience sample involved 120 MSME managers. Partial least squares structural equation modelling analysis was employed to assess hypotheses. Findings indicate a significant relationship between DT, ES, and OH, with DT influencing OP. Interestingly, ES alone does not impact OP. Structural equation modelling reveals OH as a mediating variable between DT, ES, and OP. While the proposed model is preliminary, offering avenues for further research, this study underscores the importance of emerging skills in the MSME sector, contributing to a nuanced understanding of organisational competitiveness dynamics.