Following the commitment of the new College of Medicine to locate at Lake Nona, the development of “Medical City” at Lake Nona officially began. The impact of the new cluster was expected to be quick and substantial. A decade later, policymakers and the public are largely disappointed by the lackluster impact of the Lake Nona cluster. This paper aims to understand how and why Medical City at Lake Nona has failed to meet expectations and whether there is hope for the industrial cluster to regain traction and achieve the success once envisioned.