This document discusses ISO certification for medical device companies. It notes that ISO certification has increased dramatically globally and in the United States over the past decade. Small to medium sized privately held medical device companies in the US are more sensitive to the costs of certification, which can be up to $187,000. However, these companies are increasingly seeking certification because 80% in one survey were already certified or wanting to be certified. This study aims to assess the perceived benefits of ISO certification for these small to medium US medical device companies.