Occupational exoskeletons (EXOs) provide the opportunity to reduce fatigue and physical demands, however little is known about adoption and use of such technologies especially among varying company sizes and especially small to medium sized enterprises (SMEs). Ten focus groups (including seven SMEs) were held across the state of Ohio, with participants representing line employees, management, and safety. Employees tried on a variety of EXOs and then participated in discussions focusing on the adoption and use of this new technology at their site. Consistent comments were obtained regarding donning, fitting, dissemination, and use strategies; space constraints related to EXO “footprints”; and potential undesirable impacts of EXO use. Major concerns expressed by participants were task-specific, and were related to costs and work conditions (e.g., humidity, temperature, dust). Overall, individuals from larger companies and diverse SMEs expressed a strong interest in how EXOs could help employees with repetitive tasks that were often difficult to modify or eliminate. Many concerns still exist, though, regarding specific benefits and costs, how to develop training programs on EXO use, and understanding potential adverse effects of EXO use. Findings from this study help capture the perspectives of diverse enterprises toward adopting and using occupational EXOs to reduce the risk of injury. •Focus groups used to assess adoption potential of occupational exoskeletons (EXOs).•Manufacturing enterprises shared diverse benefits of and barriers to adopting EXOs.•Major benefits related to work tasks difficult to modify or eliminate.•Major concerns included fit, comfort, cost, work conditions, and training needs.•Further evidence is needed on potential adverse effects of EXOs.