From being entities for knowledge creation and dissemination, universities are now asked to play an increasingly entrepreneurial role, involving networking and collaboration, as well as sustainability and social engagement. This consideration is in line with the fourth-stage intellectual capital perspective, which focuses on knowledge creation with an ecosystem focus. But which are the main approaches to manage and evaluate this new role? Can intellectual capital contribute to this evaluation process? The paper aims to answer these research questions by systematizing the theoretical contributions on this topic; it is based on the following steps: First, a brief historical overview of the evolution of the role of universities; secondly, a literature review on university’s third mission and its relationship with intellectual capital; finally, an analysis of the different approaches for evaluating this mission. Despite the academic and institutional efforts, there is little agreement on a set of indicators to evaluate quality in university’s third mission activities. In Italy, an “intellectual capital maturity model” (ICMM) has been built, but it needs further applications and evaluations.