Looking at the broad sweep of medical equipment management illustrated in Figure 2.1, we start by considering how to demonstrate the need for new equipment and find funding for it. We describe formal procurement processes, how these are supported by clear specifications and tendering and how different models can be compared to choose the best one. We show that acceptance and commissioning require thought, planning and preparation, whether dealing with single or multiple devices or complex installations. User training and support is vital to keep equipment operating effectively, and we show that effort in these areas is as important as good maintenance in managing risk. We introduce the differences between contract and in-house maintenance and show that, even at the end of its useful life, equipment must be condemned and disposed of with due regard for organisational governance and external regulation.