As a direct result of a call for research proposals from CIMA (The Chartered Institute of Management Accountants) and the Design Council, a research proposal was developed that built on previous research by Larsen (1996a, 1996b) into product and business development strategies in small and medium-sized enterprises and later research into the success factors of high-growth medium-sized enterprises (Larsen, et al., 1998;Tonge, at al., 1998).The original research survey and preliminary analysis was conducted during the period January 2000 to March 2001 with ongoing reviews and analysis of findings up to May 2004. The primary objective of the research project was to identify possible product and service design and management accounting factors that could provide some explanation for the improved performance of some medium sized enterprises and, in so doing, be exemplars to less successful medium sized enterprises.