Research problem: Revolution Industry 4.0. forces companies to face specific competence-related, technological, organizational and even ethical challenges. The use of innovative “tools” associated with that revolution not only brings new technological challenges, opportunities to build new competitive advantages, new areas of activity, and new types of business benefits but also doubts, questions, or even pathologies and paradoxes. Sometimes, entities that do not fully understand the essence of the new concepts, methods, or techniques use them incorrectly or abuse them for private goals and expose themselves to criticism—sometimes even social condemnation. These are examples of the lack of Corporate Social Responsibility (CSR) of these organizations. This situation also has reached co-creation. In theory, it is a very positive concept, aimed at building competitiveness, or various types of competitive advantages of companies by creating value for clients with their participation. In economic practice, unfortunately, it is not always successful. Purpose: The main purpose of this paper is to identify and characterize the key paradoxes and areas of potential pathologies of creating competitive advantage based on co-creation without CSR in the case of companies operating in the age of Industry 4.0. Originality/value of the paper: A theoretical study based on the extensive literature review describing paradoxes, ethical and CSR problems of co-creation in organizations creating competitive advantage in the age of the Fourth Industrial Revolution and a qualitative methodology of research. This study attempts to systematize paradoxes of co-creation and the areas and industries in which the related pathologies of co-creation occur particularly often and distinctively in economic practice. The empirical studies were conducted as a review of case studies of companies that use the concept of co-creation in an irregular way (paradoxical or with pathologies). This study identified and characterized the key 31 paradoxes and pathologies of creating competitive advantage based on co-creation in the case of 14 companies operating in the age of Industry 4.0. Implications: The identification of main dilemmas, paradoxes and pathologies of co-creation; signaling the role of governance and CSR in processes of the valuable use of co-creation in the age of Industry 4.0. Based on the observations described in the paper, it is worth recommending that when becoming involved in co-creation, one should observe ethical standards and assumptions of CSR, and require the same from partners and other parties involved. Otherwise, the risk is that instead of co-creation, the result achieved will be exactly the opposite to that intended, which is co-destruction, and condemnation instead of glory. This is why it is worth considering the paradoxes that are key to co-creation and approaching solutions in a conscious way.