The paper focuses on the role of small and medium-sized entrepreneurship in the innovative development of modern countries and assesses its level in the Russian economy. We analyze the main strategic documents aimed at the innovative development of the Russian economy and support for small and medium-sized entrepreneurship. In addition, we discuss the current Russian policy regarding small and medium-sized knowledge-intensive entrepreneurship in recent years as part of the overall innovation policy and evaluate its effectiveness. Besides, we pay particular attention to the institutional and infrastructural problems hindering the development of small and medium-sized high-tech entrepreneurship in Russia. In this regard, we discuss the growth potential of small and medium-sized knowledge-based entrepreneurship in Russia and the conditions for its dynamic development.