This study investigates the persistent issue of cash shortage in India's Small and Medium Enterprises (SME) sector through a systematic review and metanalysis. Drawing from over 70 sources—including academic articles, theses, reports, and databases—the research identifies key financial constraints such as limited access to formal credit, poor cash flow management, and in-adequate working capital. Traditional literature review models, while foundational, lack contextual relevance and analytical depth for Indian SMEs. To address this, the study employs digital tools like PRISMA, PICOC, and VosViewer, ultimately selecting metanalysis as the most suitable meth-odology for synthesizing financial data. The findings reveal significant gaps in existing research, particularly at the micro-enterprise level, and propose a replicable framework for diagnosing fi-nancial distress. This approach enhances the precision of literature reviews and supports evi-dence-based policymaking, offering actionable insights for researchers, financial institutions, and government bodies aiming to strengthen SME resilience and sustainability.