Universities and higher education institutions have an important role in the development and promotion of the culture and destiny of a country. They use the resources of the community and serve to it. Continuation of such a relationship and the consent of both parties requires that the communication and accountability of these institutions to society be transparent and timely. For this purpose, complete, accurate and transparent reporting of universities and institutions of higher education is essential. Accordingly, to achieve this goal, universities and higher education institutions must seek comprehensive criteria and standards to provide comprehensive and transparent reporting. However, in order to achieve greater success and better and clearer accountability, universities and higher education institutions are required to observe standards that, in addition to completeness and comprehensiveness, also have strong theoretical foundations so that they can be accountable in unforeseen cases. In this study, a comprehensive review of the history, laws and regulations of related institutions, the principles used in accounting and financial reporting of universities, especially medical universities, is discussed. This study shows that over time, the financial reporting system of universities has improved and universities to improve the quality of financial reporting to provide relevant information for optimal decision making managers and improve their level of accountability to the public, always looking for the use of new accounting systems and financial reporting and in this regard, actions and efforts have been taken to change the reporting approach to the accrual system and improve the quality of financial reporting.