Underpinned theoretically by the capabilities perspective, the purpose of this study is to identify capabilities in high-technology activity within the Irish economy. A deeper understanding of the capabilities that underscore the economy at present is needed to determine the strengths to build on and how they can be cultivated for future economic growth. In particular, this study focuses on the evolution of capabilities, both technological and those that are more intangible, such as managerial expertise and their source of development. The argument underpinning this study is that analysing industrial dynamics using aggregate data on employment, trade and numbers of firms in distinct sectors provides an incomplete picture. Such an approach fails to capture evolving technologies that may cross sectoral boundaries. Therefore, in this study, a unique methodological approach that uses an analysis of highly specified products and services produced in the economy is employed to identify high-tech capabilities. More specifically, the approach is applied to the case of medical technology activity in Ireland. The evolution and nature of capabilities is examined using an exploratory analysis of the medical technology cluster in the West of Ireland in particular.