The implementation of environmental management accounting (EMA) in Mittelstand companies is an uncharted area. Therefore, the aim of this study was to identify the ways, benefits, and disadvantages of implementing EMA in such companies. The choice of the approach and method depended on the following reasons: As the observed phenomena took place inside a company and depended on the attitudes of its members, an interpretivist and qualitative research approach was used that regarded a company as a socially constructed entity. The research was executed with a top-down deductive method starting with a literary review (on Mittelstand-like companies using EMA), and leading to hypotheses concerning the research aim. These assumptions were tested in a qualitative case study using a German Mittelstand company from the printing industry. To this end, the study used the company’s files, personal notes from management meetings, and interviews with experts from the focal company offering the deepest insight in the focal company. The analysis found two different results. Mittelstand companies will have trouble with implementing EMA. However, after having done this, they will only experience benefits and no disadvantages. During the EMA implementation there will probably be delays due to lacking expertise, conservative attitudes, and disturbed channels of information among the staff. However, these obstacles can be overcome with external experts guiding the EMA implementation, and with financial resources to pay them. EMA will then enable a Mittelstand company to track the flows of hazardous and harmless physical entities alike and its associated environmental and conventional costs. With this information the strategic management accounting (SMA) will be able to reduce these costs, to develop eco-friendly products, and to increase its resource efficiency, profits and competitiveness. In a Mittelstand company EMA should therefore be placed at the interface of proper accounting and SMA. FCA, ABC, flow cost accounting, input/output analysis, and EBSC seem to be the optimal methods to track and analyse a company’s physical flows and its related conventional and environmental costs. The former cost type depends on the quantities of the resources, with the latter one depending on the production of waste, the excessive use of water, wood, fuel, electric energy, hazardous chemicals and the process they are used in. To capture these costs it is best to use a set of primary metrics (reflecting the quantities of the resources) and secondary metrics (focussing on the flows and dangers of these resources). Measuring environmental costs of hazardous substances is difficult, since the production processes they are used in depend on chancy circumstances like accidents. Instead, it is also possible to use an EMA that only calculates the amounts of wood, water, waste, fuel, and electric energy needed for the use of hazardous substances. After multiplying these costs with a numerical and empirically obtained factor, the related environmental costs can now be measured both accurately and easily. Such a simplified EMA seems to be a promising method for Mittelstand companies with low technical skills.