This study aims to present the relationship between universities and small and medium-sized enterprises (SMEs) through a systematic literature review. SMEs play an important role in economic development. Similarly, universities are important actors in the innovation system. To fulfil the study objective, data were collected from the Scopus database. The bibliometric results found, using bibliometrix software, reveal that this topic first appeared in the literature in 1995 and entered a growth stage in 2014. Systematically, studies have focused mostly on European countries and the emphasis in cooperation is on knowledge transfer. In addition, the results show that SMEs form cooperative relationships with universities in search of competitive results. However, the main difficulty with regard to the establishment of such relationships is a lack of knowledge in SMEs about university programmes that can support them and about how to access such programmes. Therefore, it is suggested that universities should establish more effective communication channels in order to reach this type of firm.