Sustainability is no longer an optional facet of production. Concrete actions are needed from every actor in society to achieve more efficient, responsible, and innovative ways of producing, consuming, and living. Businesses, including small and medium enterprises (SMEs), are key actors in the drive toward sustainability. Product Service Systems (PSS) are an alternative for SMEs willing to make the transition towards more sustainable operations, but they remain an unknown quantity for many companies. In this article we present findings from two recent studies on the design of sustainable PSS for SMEs. Our main objectives are to inform designers, design managers, and policymakers about the advantages a sustainable PSS offers to SMEs seeking more sustainable operations, and discuss SMEs' operational needs should they wish to innovate using PSS.