Economic, demographic, social, technological and political changes worldwide are putting academic institutions under intense pressures. In response, universities are adopting new managerial approaches to their activities: lean, six sigma and lean six sigma. A portrait of this experience emerges from reviewing the literature published over the past decade using the databases Compendex & INSPEC/Engineering Village and Scopus. These approaches have been applied primarily on a highly localized basis to teaching-related processes or to services such as financing, data processing and building maintenance. Some of the challenges raised are not unknown outside of the university setting. The complexity of universities, the difficulties of interpreting notions such as the client, added value, and the connexions between teaching and research, make the implementation of these approaches difficult. While the few measured results available suggest that they do hold promise, their impact remains to be determined.