PurposeThis research aims to contribute to the ongoing debate on the prospective advantages of implementing accrual accounting in countries where such a transition is underway, with a focus on Italian municipalities. The research seeks to ascertain the requisite conditions, in public sector accounting mangers’ perception, for a useful transition from modified cash accounting to full accrual accounting within the Italian context.Design/methodology/approachThe methodology adopted is Qualitative Comparative Analysis, which involves conducting a survey through semi-structured interviews with accounting managers in municipal accounting departments. The sample is drawn from municipalities in the Emilia-Romagna region with populations exceeding 15,000 inhabitants.FindingsThe study shows that some stakeholders have a tangible demand for financial statement information. They believe that accrual accounting statements provide accurate insights into municipal financial health and that these statements are comparable across municipalities. All these factors together constitute sufficient conditions for considering useful the implementation of accrual accounting in local governments, in the opinion of public sector accounting managers.Originality/valueThis paper contextualises the broader international debate on transitioning to full accrual accounting in the New Institutional Sociology framework. The Qualitative Comparative Analysis is an underutilised methodology within the field of public sector accounting, and the public sector accounting managers’ point of view is scarcely investigated in literature.