New product development (NPD) has long been recognized as a critical capability of firms to develop products and services for competitive advantage. While there is much understanding of the NPD process, its application in understanding the product development process of emerging trends in innovation, such as low cost or frugal innovations is limited and as related to healthcare sector is even more limited. Through qualitative research methods we studied 11 cases of frugal innovations in surgery and explored their product development process. We compared our findings to the generic NPD process to highlight aspects deemed different or more important in frugal innovation. We found five key factors deemed influential to the development process for frugal innovations: Need, quality, feedback, multidisciplinary teams, and especially the role of existing offerings and found that these were iteratively applied throughout rather than in sequence. To leverage potential of low cost frugal innovations and remain competitive in the face of rising pressures on cost, quality and growing demand, managers and developers should consider adapting and revisiting their NPD process. This research helps extend our understanding of the applicability of NPD to emerging models in innovation studies and proposes a revised framework of NPD for frugal innovations in healthcare.