Teacher-targeted victimization remains an under-integrated dimension of school violence research. This systematic review follows PRISMA 2020 guidelines and synthesizes 56 empirical studies (2015–2026) examining how teacher-targeted victimization is conceptualized and analyzed. The review maps patterns in geographic distribution, methodology, behavioral aggression forms, perpetrator framing, and the integration of institutional variables. Findings reveal the predominance of quantitative cross-sectional designs (75.9%). Physical (n = 28) and verbal aggression (n = 26) are the most frequently examined forms, with over half of the studies conceptualizing aggression as exclusively student-perpetrated. Institutional and governance variables remain limited: 84.8% of studies include no institutional variables beyond exposure or rely solely on general school climate indicators, while governance-level constructs appear in only one study. Drawing on Organizational Justice Theory and Institutional Theory, the review advances a Multilevel Institutional Accountability Model that conceptualizes teacher-directed aggression across behavioral exposure, institutional processing, and governance architecture. The findings highlight the need for greater integration of institutional and governance variables in future research.