This study explores the influence mechanisms of digitalization, servitization strategy and the business model innovation and performance of small and medium enterprises (SMEs). It incorporates the three into the research framework of “innovation support–innovation strategy–innovation process” and presents corresponding research hypotheses. Using a quantitative approach, 468 valid questionnaires were obtained. The empirical results show that digitalization positively affects the service-oriented strategy and business model innovation, and the service-oriented strategy partially mediates the relationship between digitalization and business model innovation. This study guides the digital- and service-oriented transformation of SMEs in China.