University autonomy refers to the right of an institution to self-govern and make independent decisions without external interference. Hanoi University (HANU) is allowed to exercise full autonomy (i.e., the highest level of decision-making authority) granted by the state regarding its internal operations, academic matters, financial management, and personnel without undue interference from external bodies like the government, line ministries, or ministerial-level agencies. This chapter adopts a qualitative case study which involves in-depth document analysis, including official policy documents on autonomy, regulations, implementation guidelines, and university reports, supplemented and supported by secondary research and the insights gained from the interviews with the university leaders and managers. The collected data will unpack the university’s practices in autonomy implementation, highlighting how the university has adapted its leadership, decision-making, and accountability structures. In this way, this chapter sets out actionable recommendations that can be taken at an institutional level to advance the implementation of autonomy for the university in the coming periods and, possibly, for successfully achieving the goals of autonomy for other similar higher education institutions.