This study was intended to analyze the unit costs of medical services at Thu Duc General Regional Hospital (TDH) in Vietnam during the fiscal year 2019. A retrospective cost analysis was conducted using the activity-based costing method. Cost data covering 2019 were analyzed and presented in both Vietnamese dong (VND) and international dollar (Int$). The unit costs of medical services were estimated using the average cost method. As a result, in 2019, the total cost of medical services at TDH was 286,934,591,322 VND (38,496,263 Int$). Material costs accounted for the largest proportion of the cost structure. The unit costs of medical services ranged from 26,432 VND (3.55 Int$) to 21,305,814 VND (2,858.47 Int$), depending on patterns of the services. In conclusion, the findings can be used to support hospital management and serve as a reference for TDH’s estimation of its budget under the fee-forservice payment method. The costing method used in this work can be generalized to other Vietnamese hospitals of the same level as TDH.