Whereas the globalization of medicine since the middle of the 19th century has primarily been approached as the sociopolitical and cultural outcome of imperialism, this article argues that Western big business also played a major role through the worldwide export of standardized medical technologies. It focuses on the expansion of Siemens on the X-ray equipment market in non-Western countries during the first half of the twentieth century. This German multinational enterprise experienced slight growth from the mid-1920s onwards but relied mainly on two markets (Argentina and Brazil). It specialized in providing large-scale equipment to a few urban hospitals and engaged during the 1930s in large-scale hospital development together with local authorities and international organizations in various countries (China, Peru, and Central Africa). However, Siemens had great difficulty in expanding its business to include private doctors and inland outlets, where it faced intense competition from other Western X-ray producers. This paper emphasizes that this shortcoming stemmed from a direct application of the European strategy (high-quality, expensive equipment for hospitals) to non-Western markets, where health systems differed.