Introduction: Currently, restaurant MSMEs in the state of Tabasco, Mexico, must restructure their value proposition to face an environment that the health contingency caused by COVID-19 poses opportunities and threats to their effectiveness. However, little is known about the practices that these types of companies have carried out and the results they have obtained during the COVID-19 pandemic in the southeast region of Mexico. Therefore, the objective of this article is to identify the innovation practices that have been implemented by the MSMEs in the restaurant sector in the municipality of Teapa, Tabasco, during the first quarter of the pandemic and the results derived from their implementation. Method: A descriptive research is presented, with a non-experimental, cross-sectional methodological design and a qualitative approach, using the semi-structured interview as a data collection technique. The selection of the sample was for convenience, considering as units of analysis six MSMEs located in the municipality of Teapa, Tabasco, identified as restaurants with a la carte or regular food preparation service. The key informants were the managers or owners of the participating MSMEs. Results: It was identified that the restaurant MSMEs visited have implemented innovation practices in different areas of the company, highlighting the process innovation through changes in the way of production and distribution of dishes and implementation of rigorous sanitary protocols; organizational innovation through business associativity, infrastructure modifications and actions that promote occupational health; marketing innovation, promoting and advertising goods and services through the use of technologies and social networks, and product innovation through the development and sale of new products. From the implementation of these actions, the key informants stated having had favorable results reflected in the following indicators: customer satisfaction, profitability, use of relational capital and occupational health. Discussion or Conclusion: The challenges derived from the COVID-19 pandemic have motivated innovation in different areas of MSMEs in the restaurant sector in the municipality of Teapa, Tabasco, as a means to overcome the economic crisis in the country and the region. Therefore, it is concluded that innovation in the face of the health crisis is not an eventual need but a lifestyle that companies in this sector should adopt as part of their business culture. [ABSTRACT FROM AUTHOR]