AbstractTechnology transfer offices (TTOs) play an increasingly important role in universities, supporting researchers in translating science knowledge into commercially and socially valuable outcomes. However, the literature is limited regarding how TTOs support the technology transfer process. This study contributes deeper insight into the role of TTOs in facilitating knowledge transfer outcomes. A case study of life science commercialization in Australasian universities drew on depth interviews with senior TTO managers and industry experts, on longitudinal participant observation within a life science intermediary business to inform about supply side elements, and on secondary data. The findings emphasise the effects of wider institutional change on quintuple helix (5H) stakeholders, i.e., the environment, society, government, universities, and industry. Financialization and competition places growing demands on universities for commercializable intellectual property (IP) production. In response, TTOs have built competencies in translational engagement (trust and reputation building and boundary spanning) and value co-creation (service quality management and de-risking). Those competencies translate to a five-stage process of technology transfer facilitation: (1) Identifying, (2) assessing, (3) protecting, (4) promoting and (5) profiting. In the complex context of life science innovation, innovation networks benefit from investment in university outreach, stakeholder relationship building, tax credits, and fund matching with transnational corporations. To ensure optimal social and commercial outcomes independent oversight of the process should be maintained, by representatives from all 5H stakeholders.