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In rapidly deregulating markets, merger and acquisition driven growth represents one attractive strategic option. This option, however comes with its well-known risks and dangers. Nicholas Piramal has grown phenomenally over the 1990s, emerging as a major pharmaceutical company in India, by adopting such a strategy. Over this decade, it has acquired the Indian operations of several well-known pharmaceutical multinationals including Hoffman La Roche, Boehringer Mannheim and the R&D unit of Hoechst. The case describes how the company has managed each of these acquisitions all the way from the deal making to the post-acquisition integration phases. However, while the individual acquisitions only created the platform, sustained growth required that all the acquired units be integrated in an overall unified organisation. The case also describes how Nicholas Piramal developed such an organisation in 1997, and the structures, management processes and leadership it put in place to ensure effective functioning of the total company.