This article explores the contribution that management accountants and management control systems can give to the design and the implementation of an integrated reporting system. In particular, the case of the Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona is analysed in the aim of highlighting the role played by the management accountant in promoting the design and implementation of the integrated report in the specific context under investigation. The empirical evidence adds to the extant literature on this issue by showing the relevant role played by management control systems and by management accountants as well and, in particular, how the latter can significantly influence the whole design and implementation process at an organisational, technical, and motivational level.