Attention and assistance to enhance the role of small and medium scale enterprises (SMEs) by the government is more emphasized due to the success of SMEs in earning significant amount of foreign currency when Indonesia had to face economical crisis in 1997. This policy has been highly recognized again since the bombing tragedy in 2002; with the excellent evidence to show how important SMEs is in helping and maintaining the economic development of Bali. But in the implementation the assistance needs to be remanaged again in a more proper and appropriate way to attain the ultimate goals. The three economic potentials, agriculture in broad sense, tourism and SMEs (cottage industry included), must be developed in harmony, interdependence, support and complementary each other, if possible as synergist to obtain sustainable development of Bali. While assistance to SMEs must be done in a more coordinated way among the government technical offices, universities, NGOs, banking, and other social community institutions. By doing so, there would be no duplication or gap, nor creation of new disadvantageous problems. It could be in form of ergonomics, occupational health and safety impacts and problems in particular, and in adverse working conditions and environment in general. Therefore it is a must at this moment to carry out total approach in helping SMEs, by integrating the effort to improve their working conditions and environment, built-in within the effort to enhance SMEs'quality of life through economic assistance. In this process a total approach through SHIP approach and Appropriate Technology intervention must be done wisely and timely. By so doing, SMEs'sustainable working conditions and environment shall be attained.