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Abstract Prototypes have the potential to provoke discussion and to encourage stakeholders to play an active role during design engagements in the front-end phases of a design process. However, detailed descriptions of stakeholder engagement strategies in front-end design are lacking. The aim of this research study was to understand how design practitioners prepare and manage stakeholders for engagements involving prototypes in the front-end phases of a medical device design process. Design practitioners at companies developing mechanical and electromechanical medical devices for use in low- and middle-income countries were interviewed following a semi-structured interview guide. Interview transcripts were analysed, and inductive codes were developed. The findings suggest that design practitioners manage the group composition of stakeholders, review the project and prototype(s) with stakeholders at the start of the engagement, and show the progress of prototypes to stakeholders over multiple engagements. These strategies shed light on the importance of handling interpersonal relationships during stakeholder engagement with prototypes.