This report surveys energy consumption and barriers to energy efficiency for small and medium-sized manufacturers (SMM), and then describes several leading energy efficiency programs that address those barriers. SMM make up about 90% of manufacturing establishments but account for only about 50% of the energy consumed by industry. Despite using less energy at a given facility than their larger counterparts, SMM are good targets for energy efficiency programs. Not only do they pay higher prices for their energy and are less likely to have dedicated onsite energy managers, but smaller energy savings projects tend to save a higher percentage of total consumption. Still, barriers exist: a lack of staff resources, capital constraints, and a dearth of expert information on energy efficiency opportunities. Addressing these barriers, several leading energy efficiency programs reach out to smaller manufacturers, use innovative energy management programs and financing options, and leverage existing resources.