Business Intelligence (BI) adoption in Small and Medium-sized Enterprises (SMEs), defined as businesses with up to 100 employees, remains limited, primarily due to uncertainty about its value and application. Although BI has the potential to enhance decision-making, it is often used solely by top management, which limits its impact and fosters cultural resistance to BI tools. Despite these challenges, research on BI adoption in SMEs remains scarce and fragmented. This systematic literature review (SLR) examines studies published between 2014 and 2025 to answer two key questions: How does uncertainty influence BI adoption, and how can leadership motivation help overcome these barriers? The review identifies specific challenges SMEs face and emphasizes the need for active leadership involvement and decentralized BI usage as part of the organizational culture. It proposes an emerging framework that integrates Uncertainty Management Theory (UMT), Transformational Leadership Theory (TLT), and the Technology Acceptance Model (TAM).