Massive star formation in a low metallicity environment is investigated by studying the morphology of small H II regions in the Small Magellanic Cloud. A classification scheme based upon the symmetry of form in the light of H-alpha is proposed to make possible an examination of the properties of blister candidates with respect to nebulas embedded in a more uniform medium. A new diagnostic of size is developed to derive quantitative information about the ionized gas and ionizing stars. The asymmetrical surface-brightness distribution of many H II regions demonstrates that massive stars often form at the edge of dense neutral clouds. However, the existence of many symmetrical nebulas with similar sizes, luminosities, and surface brightnesses shows that massive star formation often occurs within these clouds. Nevertheless, the statistics of the two different forms indicate that the rate of massive star formation declines less steeply with radius across host clouds than in the Milky Way, suggesting that external triggering may play a larger role in initiating star formation. 38 refs.