Ireland has developed a highly successful medical device cluster. Most of the industry started from USA multinationals that moved to Ireland in the 1990s. An ecosystem has now developed with strong linkages between universities, start-ups, multinationals, venture capital, suppliers, and supporting industries. This paper explores the Medical Device cluster in Ireland. It characterizes the industry through the companies, innovation, products, markets, and regulatory framework. It concludes that the Irish MedTech industry is successful but has been highly dependent on USA multinationals that established themselves here in the 1990s. Based on this, we summarize the opportunities and threats the industry now faces. This is one of the first studi...