This sounds a little like a newbie question doesn't it? However, it seems to me that many SEO companies are not doing anything too difficult. If a website owner goes to an SEO company, the first thing the SEO company would do is look at their website design. Does the website have a sitemap? Does the website use pretty permalinks that contain keywords? Are breadcrumbs being used? Are header tags being using... What Do SEO Companies Actually Do?