A regional smart specialization initiative is investigated from a quadruple helix framework (industry, government, academia, and users/civil society). Based on a qualitative case study, we examine the interdependencies of actors, resources, and activities from a micro perspective. The aim is to understand the relationships and the value created between the different actors. From the results we conclude that the fourth helix should be viewed as a wholean arena where triple helix actors in different value adding relationships take on different roleswhere they create value to civil society, for example, new jobs or products for improved elderly care. In line with this, we state that the fourth helix is far more complex than limiting it to simply become a fourth separate helix of users or civil society. There is a complexity in that the fourth helix consists of both different users (including triple helix actors) as well as civil society. Users in the quadruple helix framework can also be defined in several ways depending on the context of the arena (the fourth helix) and what value adding activities they bring to civil society. Thus, users can be businesses, organizations, citizens, society, and many more things. ABSTRAIT Une initiative de sp ecialisation intelligente r egionale est examin ee a travers un mod ele a quadruple h elice (industrie, gouvernement, milieu universitaire et utilisateurs/soci et e civile). En nous basant sur une etude qualitative de cas, nous explorons les interd ependances des acteurs, des ressources et des activit es dans une micro-perspective. Notre objectif est de comprendre les relations et la valeur cr e ee entre les diff erents acteurs. Nos r esultats nous am enent a conclure que la quatri eme h elice doitêtre prise en compte dans son ensembleune ar ene dans laquelle des acteurs a triple h elice engag es dans des relations a valeur ajout ee jouent des rôles diff erentsy cr eant de la valeur pour la soci et e civile, par exemple de nouveaux emplois ou de nouveaux produits pour une am elioration des soins aux personnesâg ees. Conform ement a cette approche, nous affirmons que la quatri eme h elice est bien plus complexe que si elle se limitait a devenir simplement une quatri eme h elice distincte compos ee d'usagers et de membres de ARTICLE HISTORY