Although the importance of internal control system is widely acknowledged among large companies, an efficient system of internal control is mainly missing in most of Small and Medium size Enterprises (SMEs) in general and Swedish SMEs in Umea in particular. This research is a humble contribution to the effort to implement effective internal control systems in Swedish SMEs as it highlights the importance of having a sound standardized internal control system in SMEs. The research applies an inductive approach in qualitative semi-structured interview and grounded theory as a method of analyzing the data collected from purposefully sampled small and medium size enterprises in Umea, Sweden. The major features of effective internal control system that emerged from this study are found to be sound control environment, comprehensive risk assessment processes, rigorous operational control activities, effective information and communication system, and efficient monitoring and evaluation system.