Academic middle leaders play a critical role in facilitating the leadership of learning and teaching in universities. Previous research has reported the undervaluing and under-resourcing of these academic middle leadership roles. To promote a greater understanding of academic middle leaders, middle leading and middle leadership of learning and teaching in universities, a comprehensive systematic review of higher education literature published in scholarly journals between 2010–2020 was conducted. The review found a limited yet growing literature in the field, with studies predominantly utilising qualitative methodologies, single departmental levels of analysis and topics related to leadership contexts, roles and leader experiences. Analysis revealed the complex, multi-faceted nature of academic middle leadership roles, the tensions experienced by academic middle leaders and the importance of collegial academic middle leading practices. Scholars implore universities to improve role clarity, resourcing and autonomy for academic middle leaders. Future research exploring academic middle leading practices through contemporary lenses is recommended.