There are strong motivating factors for more effective management practices at the front end of the innovation (FEI) process. Astute practices in these pre-development activities have proven to be one of the greatest differentials for success. However the literature notes that the FEI is poorly managed in practice. In fact, it is seen as the greatest weakness in the innovation process. Furthermore, insufficient industry specific studies have been conducted in this domain. Consequently there are few practical guides available to managers to help them improve their performance in this space. This paper attempts to address this deficit and expand the discussion on innovation management practices at the FEI. The study presents findings from an empirical case study analysis of a large organization operating in the medical technology industry in Ireland. We synthesized the literature to identify four critical success factors (CSFs) known to be effective in the successful management of the FEI process. From this analysis an instrument to assess best practices was developed. Data was collected from 66 engineers in the R&D discipline. The findings of the study show that the organization's FEI phase aligns well with best practice CSFs. The results also reveal that the critical success factors found in the literature are also important at the FEI in the medical technology industry. However, a difference between the level of agreement about the extent to which the CSFs are in place in the organization and the level of importance placed on these CSFs emerged. This paper contributes to knowledge by (a) assessing the relative importance of CSFs for the FEI in the medical technology industry (b) examining whether these CSFs are implemented in practice and if so to what extent and (c) providing a series of recommendations to help bridge the gap from theory to practice. (C) 2014 The Authors. Published by Elsevier Ltd.