In recent decades, the dissemination and the adoption of new public management (NPM) have been significant within the new public sector. One key innovation is the adoption of accrual accounting from business enterprise. The unresolved question is, what does accrual accounting mean in practice for government? This book analyzes the initial stage of development of an accrual accounting system in the context of regional government in Italy. It presents the accrual accounting system as a new technology and contributes to understanding of neutral tools involved in a public sector reform.