The purpose of this chapter is to perform an analysis of the bibliographical references to describe the concept of supply chain orientation (SCO) as a fundamental construct of SMEs. The concept was developed by Defee et al. (2009), who extended the downstream perspective by the upstream perspective, including forward and reverse flows from the supplier to the customer and vice versa and proposed the concept of “closed loop supply chain orientation” (Esper, Defee, & Mentzer, 2010). The main scientific contributions developed by the most representative authors, such as Matsuno, Ken, & Mentzer (2000) and Tucker (2011), have been taken into account. A further research gap refers to the specific challenges facing family businesses and small and medium-sized enterprises (SMEs) within supply chains (Schulze-Ehlers, Steffen, Busch, & Spiller, 2014).