Entrepreneurship and Innovation (E&I) is the theme of much interest in recent years. E&I is expected to develop economies, particularly, emerging economies such as Vietnam. Vietnamese government has made a lot of efforts and policies to develop E&I and achieved some good results, but, not as high as expected. The innovations in Vietnamese startups and SMEs are still limited. This chapter aims to explain the reasons for this fact. A review of data published by the World Bank, OECD, and GMI were collected to understand the whole picture of Vietnamese innovation. Then, two studies on Vietnamese startups and SMEs innovation were presented. Results of the studies show that Vietnamese startups with innovations just cover a small part of total startups, e.g., Vietnamese entrepreneurs are just a few among people starting businesses. The creativity is the main difference between the entrepreneurs and the others. Vietnamese entrepreneurs have a shortage of entrepreneurial and managerial competencies, hence, most SMEs do not follow entrepreneurial orientation to continuously make innovations. As such, their market competition, and development are also constrained. Some implications to overcome this innovation limitation are proposed.