Pivotal was founded 18 years ago as a full-service and therapeutically focused European CRO, on the principle that strategic medical advice and support together with a deep scientific knowledge should be the backbone of all clinical trials. Since inception, Pivotal has been widely recognized as an EU-CRO with a solid internal medical franchise, that could act as “co-thinkers” for our clients (and not merely as “doers”), providing as well strategic advice in the complex Clinical Trials-landscape. Today, Pivotal offers an ample portfolio of activities – that include regulatory, clinical operations, project management, medical monitoring, pharmacovigilance, audits (QA unit), data management and biostatistics services- to a wide range of clients – pharma and biotech companies; cooperative groups or “devices” companies- all in need of support to push forward their clinical research programs at either development phase– from Phase I to Phase IV, including non-interventional studies-. Over the years, Pivotal has become an almost 200-strong boutique European CRO (with >92% of employees are proper) and is legally incorporated in 12 countries across Europe, although can cover many more countries within EU – and has capacity to reach other regions worldwide via partnership with other similar trustful local CROs.