Background: The accelerated use of next generation sequencing (NGS) in oncology requires the integration of cancer genomics and precision oncology education to facilitate appropriate clinical decisions. The Molecular Tumour Board (MTB) in Ireland was established in November 2020 as a cross-institutional, educational and multi-disciplinary pilot and expanded nationally under Cancer Trials Ireland as a resource for clinicians and other oncology groups. Methods: The Irish MTB program was co-designed with Roche and local Health Care Providers (HCPs) over the pillars of co-creation, co-benefitting and co-education. Individual anonymized patient cases are discussed at each monthly meeting, supported by four multidisciplinary experts that discuss genomic findings, characterized mutations and their actionability, in addition to available therapies. The standardized end-to-end process to ensure preparation and proper handling of sensitive data is managed by an independent partner. A survey questionnaire was regularly administered to the MTB attendees to evaluate progress since the MTB initiation. Results: From November 2020 until December 2021, the program has grown to a monthly meeting where 30 patient cases have been discussed and 157 cumulative participants have been part of the sessions from 16 institutions. Survey findings revealed all of participants admitted that MTBs they attended met, exceeded, or significantly exceeded their expectations and 90% of presenters confirmed that experts communicated effectively. The majority of participants (87%) considered the discussions on clinical implications of targeted therapies or immunotherapies associated with genomic alterations as the most valuable component, 80% of presenters confirmed that the MTB discussions helped them to confirm, modify or change the treatment plan for at least one of their patients, and 65% of participants were very satisfied with the insights shared around molecular profiling and biological pathways. The pilot MTB has now been incorporated by the national trials group, Cancer Trials Ireland. Conclusions: The development of a national MTB in Ireland utilized pharmaceutical sponsorship and support to gather impetus for an independent national MTB managed by Cancer Trials Ireland. It offers a national forum for the discussion of cancers with specific molecular alterations in addition to complex clinical cases. Furthermore, it has created academic opportunities for the clinical application of precision medicine. Future directions will include leveraging the MTB infrastructure for research and the creation of a national Molecular Cancer Registry. Continued integration of experts will be key to secure the continuation of the national Irish MTB and to ultimately improving precision oncology delivery in patient care and trial enrolment through meaningful insights based on the collected data.