Small and medium enterprises (SMEs) are seen as an important force for socioeconomic development. To survive and develop sustainably, SMEs must organize and run their operations effectively and efficiently. In particular, improving the organization of the accounting apparatus will contribute to providing useful information for managers in making decisions. However, with the characteristics of the size, SMEs have not really interested in organizing the accounting apparatus. In addition, the legal and guidance documents in finance and accounting applied to SMEs have certain advantages and challenges. Employing qualitative research methods and descriptive statistics, the study was conducted to assess the actual situation of the accounting apparatus organization of SMEs in Can Tho City. Research results show that most SMEs have a simple and compact accounting system, or employ accounting services provided by accounting practice units. However, accountants still hold concurrent positions, so the internal control system has not been strictly managed. These results have contributed to the systematization of legal documents in the organizational structure of accounting, and at the same time, propose policy and management implications to help SMEs improve their accounting apparatus organization.