This study investigates sustainability practices' impact on resource efficiency in small and medium enterprises (SMEs) in Ghana, employing a comprehensive framework encompassing environmental and social dimensions, facilitating conditions, innovative practices, and technological innovativeness. Through a survey of 462 manufacturing SMEs, the research provides nuanced insights into the complex relationships between sustainability practices and their effects on resource efficiency. Findings reveal four sustainable paths: the first underscores the significance of environmental dimensions and facilitating conditions in the absence of strong social dimensions and innovative practices. The second emphasizes the importance of environmental and facilitating conditions, even with low technological innovativeness. The third and fourth paths highlight the role of social dimensions and technological innovativeness as core conditions, supported by innovative practices. Additionally, two topologies are identified, illustrating the integration of environmental and social dimensions with facilitating conditions, and the combination of technological innovativeness with social dimensions and innovative practices. The study contributes to the discourse on sustainability in SMEs, emphasizing the need for reduced resource consumption, conservation, efficient production, circular economy principles, and waste minimization. Ultimately, achieving SDG 8.4 by 2030 for global resource efficiency relies on implementing these sustainable paths. The research adds depth to understanding sustainability practices among SMEs, shedding light on how various factors interact to improve resource management. It offers practical insights for policymakers and practitioners seeking to enhance sustainability in SMEs, emphasizing the importance of a holistic approach that considers multiple dimensions of sustainability.