The medical technology sector consists of numerous small niche markets. Approximately 95% are small and medium sized enterprises, many of which are start-ups that develop technological breakthroughs for the healthcare sector. The competition in this sector is highly global. In addition, firms that originate from countries with small home markets, like Sweden, are therefore often pushed to an early internationalization process while commercializing their product innovations. Although the potential demand for the medical technology innovation is global, institutions such as the regulation and financing of the healthcare sector are nation specific. Little is known about how the combination of specific industry context factors influence the internationalisation process in itself and its subsequent outcomes. The overall research purpose in this thesis is therefore to explore how and why the medical technology context influences new venture internationalization. I use a qualitative research method with two in-depth case studies from the medical technology sector to answer my purpose. My thesis contributes to the international entrepreneurship field in several ways. The overall contribution is to illustrate how our understanding of the internationalization process changes when we study a specific empirical context given certain particularities and distinctive factors. The most distinctive factor is that the medical technology sector is embedded in different socio-political systems across nations where the healthcare sector is a concern of each nation’s internal affairs. This means that each country and even regions within a country has its own distinctive regulative, normative and cultural-cognitive healthcare dimensions that affect both sales patterns and internationalization process. Operating in such abusiness-to-institution context leads to a complex sales process as well as a slow and focused internationalization process. The combination of industry particularities also affects the types of capabilities and networks that are critical during an international new venture’s early development. The results also show that various types of networks are needed besides business and social ones, such as scientific, institutional and opinion creating networks. In addition, the need for more specific financial, scientific and regulative capabilities is paramount to complement the technological, marketing and entrepreneurial capabilities.