Rice husk is the outemost layer of the paddy grain seperated from the rice grain during milling process. With approximate five millon tons of rice husk annually generated in the Mekong Delta, Vietnam (MD), it is one of the most important by-products of rice production. A survey of 85 representatives of rice millers in four provinces of Can Tho, An Giang, Dong Thap and Tien Giang was conducted in April – October 2015 to analyze the current uses of rice husk and the economic efficiency among these uses to the rice millers in the MD. The result shows that there are three main uses of rice husk in the rice husk millers in the MD, namely drying paddy (10%), producing and selling rice husk briquettes and pillets (29%) and selling raw rice husk (61%). Raw rice husk is sold to middlemen, other rice husk briquette and pillet producers, rice dryers, brick producers, alcohol and wine refiners. 22% of the studied rice husk millers has installed the briquette and pillet machines. Producing and selling rice husk briquettes and pillets brings highest profit to the rice millers. However, producing rice husk briquettes generates a lot of dusts and particles harming for the environment. Besides, the price of raw rice husk has increased dramatically in the the last three years of 2013 – 2015 due to the fast expansion of briquette and pellet instalation in the MD.