Regional financial management is increasingly important in achieving development goals and maintaining regional economic stability. This study aims to examine the impact of internal control on regional financial management accountability through a systematic literature review approach in the realm of qualitative research. The results of this study reveal the complexity of the relationship between internal control, financial accounting systems, achievement of value for money, presentation of financial statements, accessibility of financial statements, implementation of good governance, and other factors that affect the accountability of regional financial management. Despite obstacles such as lack of understanding, lack of qualified human resources, and lack of support from local leaders, serious efforts to overcome these obstacles can help internal control run effectively. Overall, internal controls play a central role in creating an environment that supports more accountable and efficient regional financial management to ensure sustainable economic growth and the well-being of local communities.