Design thinking (DT) has recently gained in popularity with knowledge intensive business services (KIBS) seeking to increase innovation effectiveness. DT provides organizations with an iterative framework that supports problem-solving, using a human-centered approach to support innovation (Brown, 2009; Chasanidou, Gasparini, & Lee, 2015). This study aimed to investigate the effects of appropriability and capabilities on DT implementation and innovation performance in a KIBS. The study’s methodology is a systematic review that provides an analysis of the relevant literature evidence-based research approach. Using thematic synthesis, this study analyzed and aggregated relevant literature on organizational appropriability, innovation capabilities, and DT according to results from 49 studies. This article found the level of appropriability strategy both inhibits and facilitates the development of a collaborative partnership to support innovation. Collaboration with clients and strategic partners goes hand-in-hand with the importance of a formal appropriability mechanism (Miozzo, Desyllas, Lee, & Miles, 2016). Findings indicate that KIBS firms which measure and dynamically utilize different appropriability strategies efficiently attain improved performance than organizations that do not. Therefore, KIBS seeking to implement DT to support innovation performance need both leadership and resource support to adopt a dynamic appropriability strategy, build capabilities, encourage resources, and legitimize the viability of the DT process in the organization.