This narrative review explores the implementation and effectiveness of IT governance models in organizations undergoing digital transformation. The objective is to identify key frameworks, evaluate challenges, and highlight best practices across public and private sectors. Literature was gathered through systematic searches of academic databases including Scopus and Google Scholar, using keywords such as "IT governance models," "digital transformation governance," and "healthcare IT governance." Studies were selected based on inclusion criteria that focused on public, private, and nonprofit organizations from both developed and developing countries. The review reveals that models like COBIT, ITIL, and ISO/IEC 38500 have consistently demonstrated positive impacts on organizational transparency, accountability, and service delivery. These models also facilitate improved risk management and stakeholder satisfaction. However, the findings indicate that systemic barriers—such as limited resources, resistance to organizational change, and lack of interoperability—significantly hinder implementation, particularly in low-resource settings. Comparative studies show that while developed countries benefit from standardized governance frameworks and robust digital infrastructures, developing countries face unique socio-cultural and policy-related obstacles. This study emphasizes the importance of tailoring governance strategies to local contexts, investing in digital literacy, and promoting participatory decision-making. The implications are relevant for policymakers, institutional leaders, and IT professionals seeking to improve governance outcomes. This review identifies COBIT, ITIL, and ISO/IEC 38500 as core frameworks for improving organizational performance, but highlights major challenges in resource-limited settings. It calls for context-sensitive adaptation and further research to translate theoretical models into practical digital governance solutions