The concepts and theories of small state studies, a sub-discipline of international relations, have been connected to Western political development, making their applicability in regions outside of Europe questionable. Using the framework of the English School, the present article aims at identifying the main elements of small state theory which are needed to be altered to make it suitable for the Middle East and North Africa. Investigating the regional manifestation of main primary institutions which form the basis of the analysis of small states (namely statehood, sovereignty, conflict and cooperation), the research concludes that the leverage of Middle Eastern small states is highly different than it is expected by traditional small state studies, especially due to the regional norms related to statehood and conflict. Consequently, changing our conceptual framework of "small states" to "small regimes" would be also necessary to better interpret how such entities behave in the Middle East or other regions of the world.