Vietnam's higher education is highly centralized in terms of its governance and management. A couple of higher education reform plans have been introduced over the past decade but they seem to result in poor outcomes. This paper addresses the challenges faced in the areas of governance, quality assurance and finance by a "key" university located in the middle of Vietnam. These are explored by means of a case study approach involving interviews with a cross-section of significant former senior managers, current senior managers and current middle managers. Reform at this university is proceeding at a very slow pace. The impediments are both institutional and national. The implications of the case study for the reform of higher education in Vietnam are discussed.