The purpose of this study is to determine the effect of management accounting practices on the performance of small and medium sized enterprises (SMEs) in Can Tho City. The survey results collected 144 questionnaires used to survey respondents who were managers at all levels, chief accountants, and accountants of small and medium enterprises in Can Tho City. Quantitative research was performed using SPSS 26 software. Research results show that five factors within management accounting content have a positive impact on operational performance in small and medium-sized enterprises, including costing systems, budgeting systems, information for decision making, strategic analysis, and performance evaluation. Among these, costing system factors have the greatest influence on the performance at Can Tho City's small and medium-sized enterprises. Based on the findings of the research, the author has proposed recommendations to assist small and medium-sized enterprises in improving their ability to successfully apply management accounting techniques, thereby improving competitive ability and contributing to the enterprises' long-term sustainability.