This article examines how Siemens’s molecular imaging group incorporated design thinking principles into R&D to regain market leadership. Marked departures from its past practice included a “universe of possibilities” for lifetime customer value; multi-iteration “leapfrog concepting” ahead of prototyping; and adherence to an “innovation metric” that enabled simultaneous consideration of customer value and business cost. These elements gave rise to a dynamic capability, “creative forbearance,” which supported the innovation team’s unbridled creativity while building in patience for introducing new features to its product platform. This case illustrates how design thinking can be integrated in settings replete with technological and customer complexity.