The aim of this chapter is to understand the determinants of the creation and growth of high-tech small to medium-sized enterprises (SMEs) at a regional level as industry matures. The biotech sector is examined to understand the role of local environment in the economic valorisation1 of scientific results.We specifically investigate the influence of the determinants of the creation and growth of biotech SMEs: a scientific and technical profile of a region and the size of the local market for biotech products and services.