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Technology firms with ‘non-conventional’ applications encounter extraordinary obstacles on all four dimensions of legitimacy (cognitive, moral, pragmatic, regulative). These obstacles are, compared to typical innovation challenges for emerging technologies, additionally reinforced by circumstances, requirements, and constraints arising from the dominant ‘traditional’ market. Previous empirical work has not examined the difficult quest for legitimacy to deal with such aggravated market conditions. Therefore, our qualitative study explores entrepreneurial firms in the non-conventional health technology sector. In order to overcome the legitimation obstacles in this contested sub-sector, the firms adopt strategies within three central themes. Each strategic theme addresses primarily one (or two) types of legitimacy, yet demonstrates legitimacy-building across the other dimensions as well. We call this positive ‘spillover’ effects. By highlighting three strategic themes, we guide start-ups and SMEs in nascent markets to build legitimacy on all dimensions, particularly for technology applications that lack widespread public support and acceptance. [ABSTRACT FROM AUTHOR]