In this study, we employed the survey design to examine e-procurement implementation on the performance of small and medium enterprises (SMEs) in Ghana. We used a sample of 86 respondents including owners, managers and procurement officers. Our findings reveal that e-procurement is moderately used in firms, and its usage significantly enhances procurement efficiency, reduces costs, and fosters stronger supplier relationships, thereby positively influencing overall firm performance. Nonetheless, inadequate information technology (IT) infrastructure, a shortage of skilled personnel, high implementation costs, and security issues impede broader adoption. These obstacles demonstrate the necessity for targeted investments in technology and training initiatives to facilitate effective implementation. Overall, our findings provide valuable insights into policymakers and practice within the SME sector, and beyond.