Innovation intermediaries are increasingly becoming an essential component of regional innovation ecosystems. Despite their rapid proliferation, they are often treated as peripheral actors in the literature with little regards to the way they emerge, change, improve and/or evolve overtime. In this paper, I systematically review the literature on innovation intermediaries with a particular emphasis on (1) the roles they assume, (2) the challenges they face, (3) and the value they provide. The results of this review reveal that, at the moment, we still lack a comprehensive account that allows for benchmarking the performance of innovation intermediaries in general, and their operating dynamics in particular. Building on the theory of social capital and adopting an intermediation-as-process approach, I identify three key innovation intermediation processes—legitimation, coordination, and generative appropriation—that explain the way these organizations create and capture value from their active involvement in the innovation process. I argue that reinforcing these three interrelated processes help drive the evolution and survival of innovation intermediaries as separate autonomous entities.