This paper explores patterns of adoption and use of information and communications technology (ICT) by small and medium sized enterprises (SMEs) in both the North West region of England and the Genoa region of Italy. Here we present the results of this two region survey drawn from two economically significant sectors: high technology manufacturing and food processing. Our main objectives were to explore and compare ICT adoption and use patterns by SMEs in the two regions to identify factors enabling or inhibiting the successful adoption and use of ICT, and to explore the impact of ecommerce on the SMEs. While our main result indicates a generally favourable attitude to ICT amongst the SMEs surveyed, it also suggests a number of differences between the two regions. English SMEs report greater uses of sophisticated ICT applications but Italian SMEs make more use of basic ICT functionality. English SMEs also report more focus on operational matters and often ignore strategic considerations, unlike their Italian counterparts. Having said that, the English SMEs pay less attention to applying ecommerce but appear to make more effective use of the Internet than the Italian SMEs.