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By the mid-2000s, no segment of the $180 billion global medical device industry was as dynamic as the market for drug eluting stents (DES). In the United States, which accounted for nearly three-quarters of the total DES market, only two companies had regulatory approval to sell the small devices: Johnson & Johnson and Boston Scientific. In combination, these two organizations expected 2005 DES sales of approximately $5.5 billion - an increase of 36% from 2004. Forecasts called for the segment to exceed $7 billion by 2008. Driven in part by its size, the DES market was among the most competitive and challenging sectors in the medical device industry. The competitive landscape was marked by intense rivalries and plagued by fierce litigation over intellectual property. Yet, it was also characterized by complex intercompany partnerships, collaboration, and licensing deals. Although DES had been shown to significantly reduce restenosis rates, new safety concerns were emerging related to the development of life threatening blood clots linked to DES. Some controversy also existed regarding the cost / benefit of drug eluting stents, with many hospitals losing money on complex procedures that involved the placement of more than one DES. Product recalls and program failures were common as companies sought to bring new DES technologies to market. And, against this backdrop, the segment was characterized by dramatic swings in market share as interventional cardiologists shifted their loyalties in response to new product releases, incremental device innovation, and negative publicity generated by the many challenges encountered by DES manufacturers. Despite these challenges, the future for drug eluting stents looked promising. This paper explores the medical device industry and examines the unusual story of drug eluting stents as one of the sectors most dynamic and complex segments.