This article presents the results of the research which deals with the current level of development of small and medium enterprises (SMEs) in Sverdlovsk region. The study analyses the statistics of entrepreneurship development as well as Russian and international experience in this sphere. It also includes a sociological survey of entrepreneurs’ satisfaction with the business climate in the region. The research was aimed at elaborating guidelines for the long-term development of a regional entrepreneurship support system. This system seeks to facilitate the implementation of the ‘Strategy for the Development of Small and Medium Enterprises in Sverdlovsk Region before 2030’. As a result, an amalgam of strategic responses for the development of SMEs is presented. The completed response comprises measures intended to address the problems entrepreneurs face by developing SME support tools; to solve the endemic problems of the sector by improving the system of regional SME support; and to promote the realization of concrete priority areas for entrepreneurship development.