Higher education institutions (HEIs) are one of the main actors in promoting transformation towards sustainable development because of their leadership role in educating future leaders, their ability to deal with environmental and socioeconomic problems, and their creation of partnerships with social entities. However, HEIs still need to incorporate sustainability principles into their academic, management, and governance practices, and specific actions are observed without a systemic plan. To understand this scenario, this study sought to identify which sustainable practices and discussions are most debated and implemented on university campuses. Through a systematic literature review, 670 articles were selected and categorized into four dimensions highlighting challenges and solutions. The results highlight that universities focus sustainability mainly on the operational dimension without a systematic improvement approach. Governance does not prioritize sustainability plans; only a few sustainability areas are addressed. Reports and rankings lack reliable indicators and adaptability. Academically, both teachers and students need a better understanding of sustainability, with a focus on interdisciplinary and collaborative teaching methods. Sustainable change should not be limited to developed countries and must encompass the university's mission, educational processes, external relationships, management, and extracurricular activities.