Strategic decisions like supply chain integration and interfirm value co-creation are significant to SMEs’ performance. Therefore, this paper aims to find out the relationships between supply chain integration, interfirm value co-creation, and firm performance in Ghanaian SMEs. We employed a structural equation model (SEM) to estimate the responses of 473 SMEs registered with the Association of Ghanaian Industries (AGI) to find the nexus between supply chain integration, interfirm value co-creation, and the performance of Ghanaian SMEs. Further, we test for the mediating role of innovation capability and stakeholder pressure in the relationships between supply chain integration and firm performance and the relationship between supply chain integration and interfirm value co-creation, respectively. We found a positive significant relationship between the variables. Innovation capability mediates the positive relationship between supply chain integration and firm performance. Interfirm value co-creation has a negative relationship with the innovation capabilities of SMEs. Therefore, Ghanaian SMEs can invest in technologies, which promote collaborations with external parties to create value while minimizing cost.