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Lean as a business strategy is used to improve quality and service, eliminate waste, reduce time and costs, and enhance overall organizational effectiveness. Heightening challenges in competition in recent years have prompted many small and medium-sized enterprises (SMEs) to adopt lean to enhance firms' competitiveness. This paper attempts to present an all-inclusive study and it examines various factors associated with the implementation of lean in SMEs in the U.S. The findings suggest that most of SMEs have a relatively accurate understanding of lean concept and philosophy. The primary reasons to implement lean are mainly internal, including reduce cost, improve profit margin, improve utilization of plant/facility, and maintain competitive position. A hierarchical cluster analysis was conducted to investigate lean status. It was discovered that both advanced adopters and beginners of lean are discovered. ANOVA test results show that there exist quite significant differences in terms of the degrees of lean implementation in SMEs. Varied lean tools and programs have been applied and they are positively related with firms' performance. Lastly, the paper provides evidences that major lean barriers are encountered by SMEs regarding management or people related factors as well as key knowledge and know-how. [ABSTRACT FROM AUTHOR]