Academic entrepreneurship, the creation of a university spin-off (USO) by academic scientists, is a fruitful way to transfer knowledge from academia to industry and to promote innovation. The literature mostly investigates the antecedents and short-term impact of USOs, and there is a lack of research regarding their long-term interaction with their parent universities. Building on the process approach in an inductive perspective, we conducted a longitudinal case study on the knowledge relationship between a deep-tech USO and its parent university. Our findings show that, once the USO was created, it developed a bidirectional knowledge exchange and a long-term, close as well as mutually beneficial relationship with its parent university. This knowledge exchange takes place in an undulatory model of interorganizational ambidexterity where exploration nourishes exploitation, exploitation nourishes exploration, and a shared space of ambidexterity with co-exploration and co-exploitation exists. Through the perspective of organizational ecology, we propose to conceptualize such a knowledge relationship as a university-USO knowledge symbiosis: a permanent, cyclical, proximal, socially embedded and mutually beneficial knowledge relationship between a parent university and its USO.