The iPierian case profiles a startup biotechnology company leveraging the recent development of induced pluripotent stem cells (iPSCs)—adult stem cells that have been reprogrammed to a “pluripotent” state whereby they can differentiate into approximately 200 different cell types in the body. The science in this field is in the nascent stages but the pace of change is rapid as new discoveries are made and as companies devise applications for the technology. iPierian has established itself as an early leader in the space by creating a consistent way to create high volumes of high quality iPSCs and subsequently differentiate those cells into motor neurons. The company must decide between three major directions—tools, drug development of therapeutics—in which it can steer the business and continue to develop its technology. iPierian must also make this decision in the context of the role of large pharmaceutical players in the industry with whom they can either partner or potentially compete against in the race to find successful applications for iPSC technology.