This article provides a systematic review of Lean Six Sigma (LSS) within the manufacturing industry. It explores common themes in LSS implementation, including benefits, motivation factors, limitations, and impeding factors. The review analyzed 19 case studies in manufacturing that identified significant benefits from LSS. However, the review also found gaps in the current literature around fully understanding LSS as a holistic strategy. The review developed an agenda for future research on LSS themes to help both researchers and practitioners better understand and apply LSS.