Research has highlighted a need for a specific and practical implementation framework for deploying Lean Six Sigma (LSS) in small- and medium-sized enterprises (SMEs). The success of LSS implementation in SMEs is highly dependent on the extent to which an LSS deployment programme addresses the specific properties of SMEs. In this study we have evaluated an existing framework for Six Sigma implementation for SMEs [Kumar, M., Antony, J., & Tiwari, M. K. (2011). Six Sigma implementation framework for SMEs – a roadmap to manage and sustain the change. International Journal of Production Research, 49(18), 5449–5467] using a multi-method triangulation approach. The objectives of this study were firstly to strengthen the foundations of the existing framework by uncovering evidence for some of its elements and, secondly, to identify the proposed revisions to the framework, especially focussed on its application in manufacturing SMEs. The results of our study are a collection of confirmations and revision proposals for the framework, leading to a revised conceptual framework.