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This paper investigates the interplay between financial frictions, organizational innovation and managerial restructuring among Italian small and medium-sized enterprises during the Great Financial Crisis. Using firm-level data from the VIII UniCredit survey, we find that financial constraints spurred managerial and organizational innovation, suggesting a Schumpeterian-like response to the downturn. The analysis reveals that this effect was stronger for relatively young and small firms operating in services industries. Limited entrenchment with financial institutions and propensity to engage in financial innovation facilitated firms’ organizational transformations. While we find no evidence of an across-the-board effect of public support on firms’ organizational and managerial innovations, the results indicate that public policies eased the reorganization efforts of financially constrained firms.