This study examines the structural relationship between cash-backed loans and survival of Micro, Small, and Medium Enterprises (MSMEs) in Abuja, Federal Capital Territory, Nigeria. A descriptive survey design was adopted. Data were collected from 313 respondents drawn from a population of 22,861 registered MSMEs using stratified random sampling and a structured questionnaire; sample size was determined via the Krejcie and Morgan (1970) formula. Partial Least Squares Structural Equation Modelling (PLS-SEM) was employed for analysis using SmartPLS. The measurement model demonstrated satisfactory reliability and validity (loadings > 0.70; AVE: 0.660–0.704; CR: 0.886–0.905; Cronbach's α: 0.828–0.860). The structural model explained 54.9% of the variance in MSME survival (R² = 0.549). Loan Accessibility (β = −0.065, p = 0.107) and Collateral Adequacy (β = −0.072, p = 0.221) exerted no significant effect, whereas Loan Utility/Effectiveness exerted a strong, positive, and significant effect (β = 0.831, t = 15.446, p < 0.001). The study recommends that policymakers and lending institutions should prioritize post-disbursement monitoring and financial literacy programmes to enhance productive loan utilization among MSMEs.