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Institutional work as a concept has evolved and diffused beyond roots in management and organizational studies since it was first defined by Lawrence and Suddaby (2006). A diverse literature and recent criticism call for an extensive review of the field. We conducted a systematic review of 452 peer-reviewed articles in 185 different journals published from March 2006 to December 2019. Semantic analysis revealed changes in topics over time, the rise of institutional maintenance, and a focus on individuals and agency. Using thematic analysis, we inductively categorized the claimed contributions to institutional work as theory combining, actors, contexts, institutional work types, representations, and methodology. The findings led us to develop an integrative conceptual framework for future institutional work study built around setting, motivations, types, and outcomes. We visualized the discourse around institutional work, growth of key themes from early theorizing, and an original process model.