Accounting policies are principles and practices by which an entity uses to recognize, measure and report economic transactions. Improper application of accounting policies can lead to misrepresentation of firms’ financial position and performance which consequently results in incorrect accounting information to the users. This paper aims to investigate the factors influencing the choices of accounting policies in small and medium enterprises (SMEs) in Vietnam by reviewing relevant literature to build a research model. The research model comprises of one dependent variable that is income-decreasing accounting procedures and six independent variables namely the firm size, financial leverage, incentives, auditor, accountants, and tax policies. After this, the authors collected primary data from more than 200 questionnaires sent to directors and chief accountants of the SMEs for the period 2018 to 2019. We then used Ordinary Least Squares regression method (OLS) to analyze the data. The results showed that four factors influenced selection of accounting policies in which auditors are associated with income-increasing accounting policies; and there are three factors associated with income-decreasing accounting policies which are, company size, tax and accountant. Especially, the research results indicate that company size has a significant influence on the selection of accounting policies in the SMEs. Based on the results, we propose instructive suggestions for regulators and lawmakers improve choices of accounting policies in the SMEs.