Rice straw open burning (RSOB) is a common agricultural practice in Southeast Asia, significantly contributing to air pollution, health risks, and climate change. This chapter reviews the emission characteristics of polycyclic aromatic hydrocarbons (PAHs) and nitro-polycyclic aromatic hydrocarbons (NPAHs) from RSOB in Southeast Asia, especially in Vietnam, highlighting their emission factors, size distribution, and health risks assessment. Emission factors (EFs) of fine particulate matter (PM2.5) emitted from small pile burning in northern Vietnam were significantly higher compared to spread burning in southern Vietnam and other Southeast Asian regions. PAH concentrations in RSOB smoke were significantly higher than background samples, with benzo[a]pyrene (BaP) and benz[a]anthracene (BaA) notably accumulating in PM2.5. Seasonal and regional variations of PAHs and NPAHs emission were observed, with Northern Vietnam reporting higher levels. Four-ring PAHs shifted to larger particles during the RSOB period (1.34–1.5 μm), while five- and six-ring PAHs exhibited consistent size distribution at 0.8 μm. The highest incremental lifetime cancer risk (ILCR) values were observed in rural Hanoi (3.00 × 10⁻5 for males and 3.26 × 10⁻5 for females), with ingestion identified as the most significant health risk than the dermal and inhalation pathways. Despite government efforts to promote alternative straw management practices, RSOB persists due to its low cost and simplicity. This review provides a comprehensive characterization of PAHs and NPAHs in PM of different sizes emitted from traditional local rice straw burning in Vietnam, helping to clarify the emission characteristics and the environmental behavior of PAHs and NPAHs from RSOB in Vietnam and across Southeast Asia.