This study examines the effect of microfinance institutions on the survival small and medium scale enterprises in Nigeria. Survey research design was used and primary data (structured questionnaire) is the main instrument of data collection. Five (5) small and medium scale enterprises in Delta State were selected and one hundred and forty-four (144) questionnaires were administered to employees of the selected small and medium scale enterprises. Data obtained were analysed using descriptive statistics and findings of small and medium scale enterprises profile indicated that majority of them are in the micro and small stages since they hire more than six (6) workers, and the industry is heavily driven by the service sub-sector. Again, the descriptive results revealed that microfinance institutions have had favourable effect on the survival of small and medium scale enterprises. Also, microfinance institutions make critical contributions such as increased access to credits, savings enhancement, and the delivery of business solutions. Besides, the study explicitly showed that microfinance institutions have a significant effect on the survival of small and medium scale enterprises. The study recommends that credits should be client-oriented rather than product-oriented in order to boost sustainable and rapid development in the activities of small and medium scale enterprises. More so, clients that are awarded loans should be subjected to extensive and comprehensive supervision.