The study aimed to determine perceptions of tourists towards the performance of Small and Medium-sized Tourism Enterprises (SMTEs) in the Eastern Cape Province. Eastern Cape Province is a tourist attraction area with several tourists from various countries visiting it. The study used a quantitative research approach. The study participants comprised 99 tourists who visited the province in which convenience sampling was employed. The empirical data was gathered using a semi-structured questionnaire distributed to all participants. The quantitative data was analysed using SPSS, in which descriptive statistics and regression analysis (multiple and logistic) were undertaken. Tourists indicated that SMTEs had poor infrastructure to access accommodation facilities, and the location of the facility, and service provided varied from one business owner to another. It is recommended that there must be training of the SMTEs in various aspects such as business planning, financial management, and efficient and effective operations of the business to improve their performance for profit and sustainability. Small business owners should apply and strengthen intuitive competitive intelligence practices for identifying clients, suppliers, and competitors as well as trying to outperform their rivals. The local government, through its different units and departments, must promote the tourism industry by providing full support to enhance the economic growth of the province. The Government should improve the road and technological infrastructure to ease access. In addition, the study should be replicated in other provinces to compare the results and learn from best practices in the tourism industry specifically in the accommodation sphere.