The University of Washington Medical Cyclotron Facility is a one-of-a-kind cancer treatment and research facility. At its center is the world’s only hospital-based, 50 MeV multi-particle, variable energy cyclotron capable of delivering fast neutron therapy and supporting innovative cancer research programs. For nearly 40 years, a dedicated team of engineers has supported, maintained, and improved the cyclotron facility to expand its capacity for clinical care, particle therapy research, and isotope production. Critical to the success of the facility is a robust preventative maintenance program that has allowed for an average annual downtime of just 2%. With demand for this resource only growing, the UWMCF team continually draws on both past lessons and new technologies to carry the facility forward while remaining firmly grounded in our 40-year-old mission: to provide reliable and state of the art clinical care to our patients.