Food safety represents a persistent challenge for street vendors and Micro, Small, and Medium Enterprises (MSMEs), where inadequate hygiene and sanitation practices substantially increase the risk of food contamination. This study aims to examine key determinants of behavioral change among vendors, including educational attainment, business scale, and the availability of sanitation infrastructure. Employing a conceptual article design based on a structured literature review, the analysis critically synthesizes findings from previous empirical studies, with particular attention to the role of hygiene and sanitation in reshaping food safety practices within MSMEs. The results indicate that sustained educational interventions-such as training programs and targeted outreach-significantly enhance vendors’ knowledge (with mean scores increasing from 54.07 to 73.70). Nevertheless, major barriers persist, notably the limited provision of basic sanitation facilities (e.g., access to clean water, handwashing stations, and waste disposal systems) and weak regulatory enforcement. This study proposes a three-pronged strategy: (1) evidence-based and intensive capacity-building programs, (2) the development of affordable and context-appropriate sanitation infrastructure, and (3) routine monitoring supported by transparent reward–punishment mechanisms. Effective collaboration among government agencies, vendor associations, and academic institutions is essential to ensure sustainability, shifting food safety compliance from a regulatory obligation toward an embedded organizational culture.