Systems development practice is undergoing major transformation, as many companies try to improve their practice to become more flexible, adaptable and agile. However, research provides convincing evidence that it may be difficult to become agile or even just to integrate agile processes in existing companies that are dominated by traditional practice. A recent literature study concludes that most literature and practice advice to reconcile the traditional approaches with agility. The complexity added by having and combining two “worlds” thwarts the job of IT project managers and change their role. Understanding these changes and the new role is the focal point of this work. Through a focused literature review, types of balancing are found, and motives, opportunities and challenges of balancing are mapped. Based on this work a framework of IT project managers’ role in organizations that balance agile and traditional approaches is suggested.