Robert Kaplan and David Norton emphasize that the four perspectives of their standard balanced scorecard (BSC) need to be adapted to the organizational context. Yet, we lack a coherent body of knowledge on these adaptations. 20 years after the implementation of the BSC, a literature review is warranted to investigate if and how the original BSC has been modified in practice. The authors conduct a systematic literature review of leading academic journals from 1992 to 2012 to identify and analyze the extant empirical evidence on the BSC. The authors find 117 empirical studies on the BSC, of which 27 deal with BSC-modifications. First, the authors conclude that the BSC-perspectives have been modified to match different industries, organizational levels, or functions (e.g., the public sector, information systems, supply chain management, corporate social responsibility, or incentive systems). Second, the authors use an established BSC classification, and argue that the BSC has also been modified in terms of its sophistication. This paper can only identify few examples where the BSC has become an incentive-relevant management system as imagined by Kaplan and Norton; many organizations stop at the level of a measurement system. On the one hand, this article demonstrates the versatility of the BSC and its perspectives as claimed by Kaplan and Norton. On the other hand, the lack of sophisticated implementations shed a critical light on the relevance of the BSC in practice.