Purpose -The purpose of this paper is to familiarize the reader with the capabilities of EFAB technology, a unique additive manufacturing process which yields fully assembled, functional mechanisms from metal on the micro to millimeter scale, and applications in medical devices. Design/methodology/approach -The process is based on multi-layer electrodeposition and planarization of at least two metals: one structural and one sacrificial. After a period of initial commercial development, it was scaled up from a prototyping-only to a production process, and biocompatible metals were developed for medical applications. Findings -The process yields complex, functional metal micro-components and mechanisms with tight tolerances from biocompatible metals, in lowhigh production volume. Practical implications -The process described has multiple commercial applications, including minimally invasive medical instruments and implants, probes for semiconductor testing, military fuzing and inertial sensing devices, millimeter wave components, and microfluidic devices. Originality/value -The process described in this paper is unusual among additive fabrication processes in being able to manufacture in high volume, and in its ability to produce devices with microscale features. It is one of only a few additive manufacturing processes that can produce metal parts or multi-component mechanisms.