Microfluidics (MF) has the potential to revolutionize clinical diagnostics and translational research by enabling the analysis and manipulation of small fluid volumes and particles at the microscale. However, the field has not yet fully realized this potential due to technical and incentive challenges. The authors highlight the need for improved accessibility, usability, and manufacturability of MF technologies, as well as a shift in mindset and incentives within the field to address these issues. They propose future directions for the field to advance MF technologies closer to translation and clinical use. MF technologies have made a significant impact in hematology and vascular biology due to their ability to mimic physiologic flow conditions in blood vessels and capillaries. However, their impact in other areas, such as cancer, has been more modest. The authors suggest that standardization, education, funding, and interdisciplinary collaborations can improve the adoption of MF technologies in biomedical research. They also emphasize the importance of improving usability, reducing dependence on complex equipment, and ensuring that MF devices are accessible and user-friendly. Technical challenges include the lack of standardization in design and fabrication methods, as well as the materials used for fabrication. Additionally, there is a need for better communication and collaboration between researchers, technology developers, manufacturers, regulators, users, and payors. The authors also discuss the importance of regulatory and reimbursement considerations in the translation of MF technologies from the laboratory to the clinic. They note that MF technologies may require unique billing codes, which could limit their accessibility for clinical use. The authors propose that MF technologies should be designed to better recapitulate in vivo conditions by using physiologically relevant materials and incorporating biological cues. They also suggest that standardization of design, fabrication, and usability can be achieved through the development of guidelines, best practices, and recommendations for materials, dimensions, and system integration. Additionally, the authors suggest that open-source design repositories and workshops can help disseminate MF technologies and promote standardization. To increase the adoption of MF technologies in biomedical and clinical research laboratories, the authors suggest that MF and lab-on-a-chip technologies should be standardized, educated, and funded. They also emphasize the importance of interdisciplinary collaborations and the need for a culture change in the MF field to prioritize access, standardization, and impact. The authors also discuss the importance of regulatory science and the need for regulatory tools to streamline device clearance. In conclusion, the authors identify several areas of opportunity to help rebuild, refine, broaden, and translate the MF field. These include improving the scientific fundamentals of the field, standardizing design and fabrication, innovating with scale-up and end user in mind, refining materials and designs to better recapitulate biology, physiology, and in vivo conditions, broadening the scale of sample volumes, enabling precision and personalization, and maintaining a pipeline of MF investigators and translational researchers. The authors also emphasize the importance of looking outward to other stakeholders to accelerate the translation and transformation of medicine.Microfluidics (MF) has the potential to revolutionize clinical diagnostics and translational research by enabling the analysis and manipulation of small fluid volumes and particles at the microscale. However, the field has not yet fully realized this potential due to technical and incentive challenges. The authors highlight the need for improved accessibility, usability, and manufacturability of MF technologies, as well as a shift in mindset and incentives within the field to address these issues. They propose future directions for the field to advance MF technologies closer to translation and clinical use. MF technologies have made a significant impact in hematology and vascular biology due to their ability to mimic physiologic flow conditions in blood vessels and capillaries. However, their impact in other areas, such as cancer, has been more modest. The authors suggest that standardization, education, funding, and interdisciplinary collaborations can improve the adoption of MF technologies in biomedical research. They also emphasize the importance of improving usability, reducing dependence on complex equipment, and ensuring that MF devices are accessible and user-friendly. Technical challenges include the lack of standardization in design and fabrication methods, as well as the materials used for fabrication. Additionally, there is a need for better communication and collaboration between researchers, technology developers, manufacturers, regulators, users, and payors. The authors also discuss the importance of regulatory and reimbursement considerations in the translation of MF technologies from the laboratory to the clinic. They note that MF technologies may require unique billing codes, which could limit their accessibility for clinical use. The authors propose that MF technologies should be designed to better recapitulate in vivo conditions by using physiologically relevant materials and incorporating biological cues. They also suggest that standardization of design, fabrication, and usability can be achieved through the development of guidelines, best practices, and recommendations for materials, dimensions, and system integration. Additionally, the authors suggest that open-source design repositories and workshops can help disseminate MF technologies and promote standardization. To increase the adoption of MF technologies in biomedical and clinical research laboratories, the authors suggest that MF and lab-on-a-chip technologies should be standardized, educated, and funded. They also emphasize the importance of interdisciplinary collaborations and the need for a culture change in the MF field to prioritize access, standardization, and impact. The authors also discuss the importance of regulatory science and the need for regulatory tools to streamline device clearance. In conclusion, the authors identify several areas of opportunity to help rebuild, refine, broaden, and translate the MF field. These include improving the scientific fundamentals of the field, standardizing design and fabrication, innovating with scale-up and end user in mind, refining materials and designs to better recapitulate biology, physiology, and in vivo conditions, broadening the scale of sample volumes, enabling precision and personalization, and maintaining a pipeline of MF investigators and translational researchers. The authors also emphasize the importance of looking outward to other stakeholders to accelerate the translation and transformation of medicine.