Sustainable agriculture is crucial for achieving SDG2 and building a resilient climate-food system. This study provides a nuanced understanding of factors that influence the adoption of precision agriculture technology by Vietnamese smallholder rice farmers as a sustainable agricultural solution. The study’s objectives are: (1) to provide a nuanced understanding of factors that influence adoption of precision agriculture technology by Vietnamese smallholder rice farmers; and (2) to identify factors associated with agricultural practice in Vietnam that may impact the adoption of precision agriculture technology. The study conducted 35 semi-structured interviews with smallholder rice farmers and agriculture experts. Data were analyzed using iterative thematic analysis. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was used for empirical analysis. The UTAUT constructs of Performance expectancy, Effort expectancy, Government support, and Social influence were found to be determinants of adoption. Trialability and Observability impact Effort expectancy and Performance expectancy. We also discovered that the performance of agricultural cooperatives and support of lead firms play a crucial role in facilitating agricultural technology adoption by Vietnamese smallholder rice farmers. The results confirm the applicability of UTAUT in defining smallholders’ behavioural intention and predicting agricultural technology adoption. The study also provides constructive feedback on the UTAUT model by highlighting the effect of agricultural cooperatives’ performance as innovation intermediaries and of the support of lead firms.