Previous studies have not considered one important aspect of port efficiency; seaports in different groups operate under different technologies. This study examines the technical efficiency (TE) of 43 ports in Vietnam and their influential factors using metafrontier analysis. The results show that cargo handling facilities and information technology are the most important inputs for ports, despite their varying contribution to port performance across regions. Land is important for the TE of ports in the North, whereas the cargo storage capacity is important to ports in the Central areas, and information technology is important to ports in the South. The majority of Vietnamese ports are operating under increasing returns to scale. On the other hand, each region needs a different approach. For example, in ideal situations, ports in the North could reduce berth length by up to 57% without affecting throughput. National and regional reference networks are developed to identify the leading ports at the regional and national levels and their connections with other ports.