For more than three decades the field of biotechnology has had an extraordinary impact on science, health care, law, the regulatory environment, and business. During this time more than 260 novel biotechnology products were approved for over 230 indications. Global sales of these products exceeded $175 billion in 2013 and have helped sustain a vibrant life sciences sector that includes more than 4,600 biotech companies worldwide. In this article we examine the evolution of biotechnology during the past three decades and the profound impact that it has had on health care through four interrelated and interdependent tracks: innovations in science, government activity, business development, and patient care. The future impact of biotechnology is promising, as long as the public and private sectors continue to foster policies and provide funds that lead to scientific breakthroughs; governments continue to offer incentives for private-sector biotech innovation; industry develops business models for cost-effective research and development; and all stakeholders establish policies to ensure that the therapeutic advances that mitigate or cure medical conditions that currently have inadequate or no available therapies are accessible to the public at a reasonable cost.