Small-medium sized companies competing in different industries also need to design and manage an international manufacturing network to be more competitive. Aim of this paper is to investigate the decisional process that leads to the location, design and start up process of a new plant in a low cost country for these companies by means of a multi-case studiy research involving Italian and Spanish companies. Main empirical evidences and differences of the strategic choices when locating and designing the new plants and the factors considered in the start up process are exposed