The authors have developed a five-stage methodology for evaluating the effectiveness of state support of small and medium-sized enterprises within a region, particularly in the context of foreign economic sanctions. This methodology is based on the research conducted by Russian economist O.V. Inshakov, who has proposed a new theory of production factors. The assessment indicators are categorized into 7 blocks, with the first two focusing on expenditure, specifically the amount of subsidy from the federal budget to co-finance expenditure obligations of regions related to the implementation of regional projects under federal initiatives such as «Acceleration of small and medium-sized enterprises» and «Popularization of entrepreneurship». The remaining 5 blocks assess the outcomes of public authorities’ efforts in regulating and supporting of small and medium-sized enterprises within regions affected by foreign economic sanctions. Testing of this methodology in the Southern Federal District revealed that while state support has increased in some regions in the short term, the efficiency of small and medium-sized enterprises has decreased, or in some cases, experienced rapid growth. Overall, state financial support for small and medium-sized enterprises affected by sanctions can serve as a vital tool in mitigating negative effects and stimulating business development. However, the effectiveness of such support relies on careful planning, transparency, and efficient resource allocation.