This article focuses on the theory and practice of teamwork in "top management teams" in UK higher education institutions. It is informed by some of the key findings from a recent two-year research project sponsored by the Leadership Foundation for Higher Education that investigated the different ways in which UK higher education institutions organise their "top management" and "senior management" structures (Kennie and Woodfield, 2008). The authors discuss literature from the corporate and higher education sectors on the meaning of "teamwork" in top teams (e.g. Bensimon and Neumann, 1993; Katzenbach, 1998; Wageman et al., 2008) and relate the findings to the challenges of top level team working in higher education settings. Particular issues discussed include: the terminology related to higher education top teams, areas of decision-making and time-management, team orientation and agenda setting, team behaviours and team roles, team performance and evaluation, location, logistical support and resources, and team development. The authors conclude that the challenges of top team working in higher education settings are similar to those found in the corporate sector, albeit nuanced by different organisational cultures, and suggest some key principles to help top teams in higher education institutions improve their ability to work effectively together.