Insolvency law is broadly recognized as an essential tool in well-functioning economies. A balance of mechanisms that allow for timely and effective liquidation, but also for a “fresh start” for individual entrepreneurs and the rehabilitation of viable businesses, tends to enhance creditor recoveries and lender confidence. This study examines the treatment of micro, small and medium enterprises (“MSME”) under the Canada Bankruptcy and Insolvency Act. It undertakes a qualitative examination of 200 business insolvencies in 2015, in order to try to understand the reasons for insolvency, types of debt, and outcomes of proceedings. The study reports on the results of a survey of 53 licenced insolvency trustees and 10 loan officers across Canada, in terms of their experience with respect to the barriers to small and medium enterprise insolvency. It suggests a series of legislative changes, including creating a streamlined approach to the insolvency of micro and small businesses (“MSE”), so that MSE can access formal proceedings; a deemed approval process where creditors have received meaningful notice and do not object to the proposal; increased authority for the insolvency professional, reducing the administrative burden and cost of multiple court appearances; and other measures to enhance access to insolvency system.