Industrial activities are responsible for a significant share of both global delivered energy demand and CO2 emissions. Hence, a widespread adoption of energy-efficient technologies and practices represents a crucial means for sustainable production. Adopting a novel framework of drivers for energy efficiency describing the effect of drivers on barriers in the decision-making process steps and able to account for the nature of drivers and the stakeholders responsible for their promotion, we have performed an exploratory investigation into 61 manufacturing small- and medium-sized enterprises in Northern Italy. Our findings have highlighted the importance of information and economic drivers, showing the need for enterprises to be supported not only by public institutions but also by external stakeholders involved in the supply of energy-efficient technologies and practices such as industrial associations and groupings, as well as service and technology suppliers. Moreover, our study has highlighted an almost equal relevance of both internal and external drivers. According to our findings, the increase of awareness—generating the interest to energy issues and stimulated both by external and internal stakeholders—as well as financial issues have emerged as the most critical in the decision-making process to adopt an energy-efficient measure. A preliminary comprehension of the mechanisms relating drivers to barriers in the decision-making process brought additional value to the study, highlighting the most effective and specific means to overcome the existing barriers. We have also explored the effect of several firm characteristics, such as firm size and energy intensity offering suggestions for industrial decision-makers as well as policy-makers.