This paper focuses on the expansion of Siemens on the X-ray equipment market in emerging countries during the first half of the twentieth century. The German multinational enterprise experienced slight growth from the mid-1920s onwards but relied mainly on two markets (Argentina and Brazil). However, it was overspecialized in providing large-scale equipment to a few urban hospitals and had great difficulty in expanding its business to include private doctors and inland outlets. This paper argues that these shortcomings stemmed from a direct application of the European strategy (high-quality, expensive equipment for hospitals) to emerging markets, where health systems were different.