<p>This literature review examines the role of 6G and innovation in shaping the future of telecommunications entrepreneurship. While existing studies primarily emphasize technical roadmaps, research systematically linking 6G’s emerging use cases to entrepreneurial strategies and business model innovation remains limited, creating a gap in understanding how technological advances translate into entrepreneurial value. Addressing this gap, we ask: How do 6G technologies and innovation enable new opportunities for telecommunications entrepreneurship? Using a systematic literature review in line with PRISMA 2020 guidelines, this study categorizes 6G use cases across domains such as smart cities, digital healthcare, autonomous systems, and intelligent edge computing. Findings show that: (1) 6G capabilities including terabit-level speeds, sub-millisecond latency, and AI-native architectures are catalysts for novel ventures in immersive communication, digital twins, and autonomous mobility; (2) ecosystem readiness, including supportive policy frameworks and academia–industry collaboration, is decisive in enabling entrepreneurial outcomes; and (3) sustainable and inclusive innovation strategies are essential to align 6G-driven ventures with societal needs. The study presents an integrative conceptual framework that links 6G enablers, innovation drivers, and entrepreneurial opportunities, grounded in evidence from 80 academic and industry sources published primarily between 2016 and 2025, while retaining only a limited number of earlier foundational sources where conceptually necessary. By highlighting trends, gaps, and strategic implications, this review provides actionable insights for policymakers, industry leaders, and entrepreneurs. It also lays the foundation for future research on business model development and policy integration in the 6G era.</p>