The emergence of various approaches in relationship marketing has transformed business marketing practices in managing strategic clients. In this direction, firms have embraced Key Account Management (KAM) as a relationship marketing tool for profitably managing their strategic customers. The concept of KAM has evolved and gained importance in academic literature as a distinct sub-division of business-to-business (B2B) marketing. However, the current academic understanding is very diverse and disintegrated, posing a threat to domain expansion and challenges for better managerial practice. This study reviews the extant KAM literature with a systematic review approach and tries to address this void in the extant body of knowledge. 104 research papers published between 1990 and 2022 were systematically reviewed. The results suggest a synthesized framework integrating the characteristics of numerous KAM practices and antecedents. In addition, we provide directions for future research based on the synthesis of the extant literature grounded in theory, context, characteristics, and methodology.