The shift towards lean production is gradually replacing traditional mass production, and lean accounting is also being mentioned to evaluate operational efficiency based on the lean philosophy, eliminating waste, and simplifying direct cost aggregation along the value stream to improve productivity, distribution, quality, and service. This study aims to evaluate the impact of various factors on the adoption of lean accounting in Vietnamese garment firms based on data collected from 242 survey questionnaires completed by managers and accountants of Vietnamese garment firms. Through Cronbach’s Alpha test, EFA test, and multiple regression analysis to verify and forecast information, eight determinants affecting the adoption of lean accounting in Vietnamese garment firms are arranged in descending order of influence, including leadership, size, cost of implementation, resources, accounting department, education and training, culture, and competitive pressure. Based on the findings, recommendations are proposed to management businesses and agencies to address shortcomings in the process of applying lean accounting, contributing to making it one of the most effective tools in promoting product development and continuous improvement, enhancing quality and production efficiency.