Higher education institution autonomy, as a form of governance, has become a pivotal issue in Vietnam, a nation with a strong Confucian cultural heritage and a state-controlled political system. Over the last three decades, public university governance in Vietnam has experienced a shift towards decentralisation, particularly following the Doi Moi economic reforms. This movement is accompanied by an embrace of the redesign of governance structures geared towards reduced direct state control and greater independence and self-governance for individual universities. This chapter sketches out the historical development and provides a comprehensive overview of the current state of university autonomy by reviewing the key dimensions of organisational, academic, staffing, and fiscal decentralisation, in addition to discussions of policy measures implemented to propel university autonomy in Vietnam. Reliant on documentation-based and comparative educational research methods, the chapter offers a contrastive analysis of the key features of university autonomy in the current governance models of Vietnam in relation to the theoretical models discussed in Chap. 3 . In this regard, decision-making authority, accountability, and self-responsibility are found to be interconnected and form an (eco)system that unfolds insights into the complexities of autonomy across the higher education sector in Vietnam.