At best, industrial design is a cultural force that brings cultural values into products, and thus enriches our lives. However, whether this happens depends on how design is organized in companies. In traditional Arts and Crafts industries, design has been an institutionalized means of competition for decades. How about in manufacturing, in which design has to find its way into company practices through the company hierarchy? This book studies how machine manufacturing companies and medical equipment producers use industrial design. The focus is mostly on Finland. However, we compare our results with well-known international examples to assess the position of design in the present manufacturing economy. We develop a conceptual model for benchmarking the use of design in companies, and use it to show how the position of design could be improved in manufacturing companies. The report is part of Sitra’s Research Programme on the Finnish Innovation System.