Nippon Boehringer Ingelheim (NBI) is an operations unit of Germany’s Boehringer Ingelheim (BI) Group, one of the world’s top 20 pharmaceutical companies. NBI has a pharmaceutical research institute and manufacturing site in Japan, providing pharmaceutical products in the areas of the respiratory, cardiovascular, and central nervous systems, amongst others. With approximately 1,700 employees, NBI had net sales in 2006 of JPY 124 billion. NBI experienced various challenges in the period from 2001 to 2003. To overcome these challenges and achieve ambitious targets, NBI’s leadership with the help of employees successfully introduced the BSC as a major performance and alignment management tool, implementing the methodology first at the enterprise level and later cascading it to the divisional and departmental levels. In 2005 and 2006, NBI became the fastest growing pharmaceutical company in Japan, and its success has continued into 2007. NBI has achieved and established the potential for further development due to two primary factors: the innovative profile of its medicine and an increasingly strong and efficient organization.