High failure rates in medical technology startups have cooled investors’ sentiment and consequently hindered innovation in this space, despite rapid scientific and technological progress. This book introduces a practical and evidence-based methodology that applies the scientific approach to decision-making in medical technology ventures. Drawing on research and field testing with real startups, it provides a structured approach for identifying, mapping, and prioritizing the complex decision-related problems that determine success or failure. By applying a scientific approach not just to clinical trials but also to the most critical business problems at each stage of a venture’s development, entrepreneurs and investors can improve prediction accuracy, mitigate cognitive biases, and thereby implement faster paths to market. The proposed methodology combines conceptual rigor with visual maps, making complex decisions more manageable and transparent. Entrepreneurs and investors alike will find in this book a pragmatic framework for navigating uncertainty, making better and timelier choices, and ultimately increasing the probability of successful value creation in the demanding landscape of medical innovation.