Presbyterian Saint Luke's Medical Center selected Path21 Architecture to design a new hybrid operating room to incorporate advanced intra-operational imaging technology. The OR provides the facility with advanced surgical capabilities that will be used to perform a wide range of emergent and non-emergent procedures. Included in the room are twin neonatal support spaces to provide high acuity level support to pregnant mothers and their newborns, a working area for the nursing team, the control room for operation of the integrated technology within the room, and other required support spaces. The GE Discovery IGS 740 angiography system implemented into the space provides the surgical team at Presbyterian St. Luke's with high precision imaging capabilities during surgical procedures. Implementation of this technology required an engineered conductive flooring system that will assist in the location accuracy of the automated imaging system. A new air handling unit with support structure and screening was also installed as part of this project to supply filtered and tempered air to the new hybrid operating room. The high level of coordination required for this type of project provided an opportunity for the design team, construction team, and technology vendors to demonstrate to the owner that the successful implementation of a hybrid operating room technology in an existing building is achievable with the right team.