This paper examines the early internationalization process for a MedTech start-up in Boston. It investigates the specificity of the medical sector and sheds light on challenges arising when integrating an entrepreneurial ecosystem. It helps entrepreneurs understand which resources are crucial to succeed in a highly competitive market. Our results show the particularity of Boston as a platform of change if resources are adequately used by entrepreneurs.Findings demonstrate the importance of a network to overcome obstacles but also exposes the different perceptions of what entrepreneurs expect from a foreign ecosystem compared with what it actually has to offer. This paper presents an in-depth case study of a MedTech start-up looking to internationalize in Boston due to its reputation of being the region with the most to offer the medical device industry.