External technology commercialization (ETC) is increasingly being regarded as a strategic priority by companies. ETC is the use of out-licensing to transfer technologies that are disembodied from products to other organizations. Previous research has focused on the economic and strategic dimensions but little attention has so far been paid to how ETC should be organized. This paper explores whether and how firms operating in different contexts adopt dissimilar organizational solutions for their ETC activities. To this aim, a theoretical framework is first developed that comprises the key constitutive elements of ETC organization and a number of firm-level and deal-level factors that are supposed to influence organizational design choices. Based on a multiple case-study analysis involving 16 out-licensing deals executed in seven Italian pharmaceutical firms, the paper shows that the organization of out-licensing tasks and the allocation of decision-making power is shaped by, and adapts to, the relevance of ETC in the corporate strategy, the volume of ETC transactions, the stage of development of the technology being commercialized and the competitive threats due to the deal. The paper is believed to be useful for licensing and R&D managers who can find practical insights into how ETC activities can be organized and which critical contextual factors should be accounted for when designing such organization.