Long-term survival and growth depends on the firm’s ability to exploit its current competencies while exploring fundamentally new ones. Finding the balance between exploration and exploitation is called ambidexterity in the literature. This paper is a comprehensive review of organizational ambidexterity theory. Creating and maintaining the capacity to simultaneously pursue these contradictory activities is an extremely difficult managerial challenge. Although, several aspects are well-researched, especially structural and leadership solutions in large, multinational enterprises, but little is known about: (1) how ambidexterity forms in earlier growth stages? (2) What are the key drivers and elements of organizational context that makes organizations able to become ambidextrous? (3) What is the role of different managerial levels in this formation process? Reviewing the literature, in this article the author would like to introduce the paradox of exploration and exploitation, the tensions and different aspects of ambidexterity, the fields current stage and some important research gaps.