A new boundary element formulation is developed to analyze two-dimensional size-dependent piezoelectric response in isotropic dielectric materials. The model is based on the recently developed consistent couple stress theory, in which the couple-stress tensor is skew-symmetric. For isotropic materials, there is no classical piezoelectricity, and the size-dependent piezoelectricity or flexoelectricity effect is solely the result of coupling of polarization to the skew-symmetric mean curvature tensor. As a result, the size-dependent effect is specified by one characteristic length scale parameter l, and the electromechanical effect is specified by one flexoelectric coefficient f . Interestingly, in this size-dependent multi-physics model, the governing equations are decoupled. However, the problem is coupled, because of the existence of a flexoelectric effect in the boundary couple-traction and normal electric displacement. We discuss the boundary integral formulation and numerical implementation of this size-dependent piezoelectric boundary element method, which provides a boundary-only formulation involving displacements, rotations, force-tractions, couple-tractions, electric potential, and normal electric displacement as primary variables. Afterwards, we apply the resulting BEM formulation to several computational problems to confirm the validity of the numerical implementation and to explore the physics of the flexoelectric coupling.