There have been the recent calls for additional research in order to enhance the understanding of the adoption of management accounting practices (MAPs) in small and medium sized enterprises (SMEs). This, allied to an increasing importance of SMEs around the world especially in developing countries, is the motivation for this research. This paper explores the uptake of a broad range of MAPs in 160 Malaysian SMEs firms in the manufacturing sector. The study finds that both Malaysian small and medium firms made extensive use of traditional MAPs and only selectively use modern MAPs such as non-financial performance measures related to internal processes and to customers. Results for all MAPs also indicate that a higher usage by medium firms as opposed to small firms. In most part of MAPs, medium firms adopted as twice as many small firms. The most significant differences relate to the use of decision support system and strategic management accounting. The employment of high qualified accounting staff by medium firms may as well lead the relatively higher uptake of MAPs by medium firms. Besides, the increased uptake of sophisticated management accounting practices by larger firms is in line with size being a contingent variable for explaining the use of such practices.