Value creation in business ecosystems through design thinking (DT) is an emerging area of interest for scholars and practitioners. While prior research has mainly focused on product/service innovation, insights are limited into the role of next-generation leaders leveraging DT practices in business ecosystems. This study aims to bridge this gap by employing a stringent data extraction process using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to conduct a rigorous systematic review process, including titles, abstract, and keywords analysis, backward-forward chaining, and strict quality evaluations. It develops a broad research framework linking the characteristics of next-generation leaders (context) to DT (process) tools and methods, driving business ecosystem value creation (outcomes). This is achieved through a process-based framework of antecedents, phenomena, and outcomes at distinct and multiple levels of analysis. The study also provides future research directions and practical implications that contribute to the growing field. To the best of our knowledge, this is the first study to conduct an integrative analysis of this area.