Purpose: This paper aims to address threecore questions around (1) what limitations exit with the methodology and/or its use; (2) what is the methodology's impact on performance outcomes; and (3) what learnings can practitioners and educators employ as part of the startup efforts. Methodology: A review of available peer and non-peer review literature relevant to the lean startup methodology, its limitations (pitfalls, fallacies, problems), and outcomes to address the core questions. Findings: This review identifies limitations with the methodology in several areas: business sector fit; issues associated with customer discovery; experimentation; iterating/pivoting; and the minimum viable product. Limitations may be related to the methodology, the incomplete understanding of its fundamental components, inconsistent (and non-rigorous) use of the methodology, and the inability to address risks (e.g., technological) beyond resolving market uncertainty. Also, experience related to outcomes with the lean startup reveals mixed findings due to the diverse methods, populations, and endpoints used. Such facets underly the mix of experiences seen in both the peer and non-peer review literature. This review identifies that rigorous implementation leads to statistically significant (P<0.05) outcome differences (e.g., discarding poor ideas, number of pivots, and revenue realization). Practical Implications: Practitioners and educators should consider educational, implementation, business sector, outside influences, outcomes, and investor preferences to use the methodology. Originality: This paper provides one of the first extensive literature reviews to examine what limits exist, where, and whether these are associated with the methodology or due to user, cultural, or business sector considerations. It also provides several relevant learnings for practitioners and educators to consider when using the methodology. Conclusions: Current evidence indicates that multiple issues do exist. Such limits are related to the methodology's inherent structure and user, sector, and external influence considerations. Further, outcomes vary based on study methods, variables, populations, business verticals, and implementation. Practitioners should consider some of the recommendations offered when utilizing this methodology to optimize their experience and outcomes.