This report examines how extreme heat and flooding are affecting micro, small, and medium enterprises (MSMEs) in India, with a focus on their implications for business operations, worker well-being, productivity, and economic resilience. As climate change increases the frequency and intensity of extreme weather events, MSMEs face growing risks due to their limited financial, technical, and institutional capacities. Drawing on a survey of more than 300 MSMEs, stakeholder consultations, and field assessments across textile and automotive manufacturing clusters in Surat, Chennai, and Coimbatore, the report analyses enterprise exposure, sensitivity, and resilience to climate hazards. The findings highlight significant operational disruptions, supply-chain impacts, productivity losses, and financial challenges associated with heat stress and flooding. The report identifies key barriers to resilience, including gaps in awareness, technical capacity, access to finance, insurance, and government support. It proposes pathways to strengthen MSME resilience through targeted policies, institutional support, improved access to finance, capacity building, and climate-resilient industrial development.