Poor project management in IT companies, strong industry competition, and small firm fragility are some of the most often cited arguments to justify business failure. This chapter provides an integrated view of concepts involved in information technology project management in university spin-off companies. It includes a presentation of a success story of an IT university spin-off, which from the very beginning of its activity focused mainly on project management processes. The chapter explains how university spin-off organizational structure influences the project management process and discusses important methods and approaches that can determine IT spin-off successes.