Health-tech startups are a type of software startup that uses advanced technologies to develop personalized health solutions for digital health. However, they face challenges such as high failure rates, lack of investor trust, and insufficient market demand. This study aims to explore how the ecosystem influences the development of mHealth applications in health-tech startups and to understand the critical factors contributing to their success in bringing products to market. The research employs autoethnography and archival documentation as data collection techniques. These methods are used to examine the mHealth app development process within the context of a health-tech startup and its ecosystem. The study identifies key phases in the mHealth app development process and evaluates the roles of different startup ecosystem elements in each phase. The findings reveal that ecosystem support is crucial at every stage of development, impacting the startup’s ability to launch and sustain its product successfully. This study offers practical recommendations for professionals in the field and proposes directions for future research to enhance the success and sustainability of health-tech startups.