Physical strain persists in manufacturing, particularly in small and medium-sized enterprises, as a cause of musculoskeletal disorders. While exoskeletons offer potential solutions, their effectiveness in SMEs remains understudied. Existing research on the effectiveness of exoskeletons focuses on laboratory settings and larger companies, overlooking practical challenges and benefits for SMEs. This study aims to bridge this gap by assessing the suitability and effectiveness of exoskeletons in 11 different Austrian SMEs. It seeks to guide their selection and implementation in SMEs based on field testing in 16 workplaces with 28 employees applying 5 different exoskeletons. To conclude on their applicability and effectiveness in SMEs, the test procedure included questioners and electromyography measurements. The results reveal different suitability based on trade-offs between rigidity and flexibility, physical demands and movement sequences as well as workers’ attitudes. As a result, we propose a framework for applying exoskeletons along the categories of (1) dynamics of work tasks and (2) loading on the worker, including 5 categories of feasible work tasks. This framework should help identify suitable systems and effective implementation strategies in SMEs for maximizing their benefits while mitigating risks. While further research is needed, the study provides valuable information on their implementation in SMEs, emphasizing the need for a nuanced approach considering objective and subjective performance metrics and potential benefits for SMEs.