This paper systematically reviews the drivers, implementation processes and performance outcomes of environmental management systems (EMS) in small to medium-sized enterprises (SMEs) from a management accounting and control (MAC) stance. It finds that there are various contextual, control and performance themes which require research attention. Regarding context, there is the need to: a) explore the relationship between firm size and the development of sustainability tools; b) assess the impact of context for better environmental performance and c) on adoption motivations; and d) explore how EMS affect corporate and individual accountability. Regarding control, there is the need to: a) theoretically explore the control typologies for SMEs; b) better understand the type (i.e. formal or informal) and nature (i.e. tight or flexible) of this control; and c) develop understandings of socio-ideological controls for improved sustainability. Finally, regarding performance, there is the need to: a) understand how environmental performance is defined and the interaction between its dimensions; and b) explore the relationship between EMS and environmental performance in SMEs. The paper serves as a first step to understanding MAC in SMEs, highlighting contemporary issues that are relevant for academic and professional sustainability practice.