According to the organizational learning theory, there are two types of corporate activities, exploitation and exploration, for enhancing and improving corporate performance. However, organizations are continually faced with choosing between these two conflicting activities that require different organizational structures, strategies, and environments, respectively. This study’s objective is to use a systematic review methodology to investigate how implementing organizational ambidexterity affects managerial performance in small- and medium-sized enterprises (SMEs). Although there is a general consensus about the relationship between ambidexterity and firm performance, few studies have probed into the mechanism of how it is applied to management process and what antecedents affect the implementation of OA in SMEs. The qualitative method was conducted to investigate the influence of the ambidexterity strategy of SMEs on firm performance. According to the findings, organizational ambidexterity in SMEs has a positive impact on the firm’s managerial performance. SMEs must make decisions that consider environmental factors. Making practical decisions based on accurate formation, considering organizational human resources for implementing ambidexterity, and sharing specific performance goals are all important considerations. This study is also important for SMEs’ top management teams to make proper decisions for the firm’s sustainable growth via OA, and shed new light on the literature of organization theory that operates in a more turbulent environment.