Disclaimer / Forward Looking Statements

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2 Disclaimer / Forward Looking Statements Statements in this presentation regarding Symmetry Medical Inc. s business, which are not historical facts, may be forward-looking statements that involve risks and uncertainties within the safe harbor provisions of the Private Securities Litigation Reform Act of Forward-looking statements are predictive in nature and are frequently identified by the use of terms such as may, will, should, expect, believe, estimate, intend and similar words indicating possible future expectations, events or actions. Such predictive statements are not guarantees of future performance, and actual results could differ materially from our current expectations. Certain factors that could cause actual results to differ include: the loss of one or more customers; the development of new products or product innovations by our competitors; product liability; changes in management; changes in conditions affecting the economy, orthopedic device manufacturers or the medical device industry generally; and changes in government regulation of medical devices and third-party reimbursement practices. We refer you to the Risk Factors and Forward Looking Statements sections in the Company s most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission, as well as the Company s other filings with the Securities and Exchange Commission, which are available on the SEC s website at

3 The Symmetry Story World s largest provider to major orthopedic companies Attractive business model Significant advantages versus competition Multiple avenues for growth Strong and increasing global presence Strong free cash flow generator Deep and experienced management team

4 Symmetry Medical Overview LTM Revenues: LTM EBITDA: Locations: $277 million $63 million 17 Facilities Employees: 1,819 Implants LTM Revenue $106M (39% of Total) Instruments LTM Revenue $73M (26% of Total) Cases LTM Revenue $72M (26% of Total) Other LTM Revenue $25M (9% of Total) Total Solutions Design Engineering Prototyping Manufacturing Packing Delivery Support Note: LTM data as of September 30, 2006 and is pro forma for the acquisition of Riley and Everest.

5 Products & Services Implants Cases Products & Services Instruments Design & Logistics

6 Diversified Product & Revenue Mix Revenue by Product PF LTM 09/30/06 $277 million Revenue By Geography PF LTM 09/30/06 - $277 million Ireland Implants 39% Cases 26% 12% UK 14% Instruments Other 9% US 63% ROW 11% 26% Pro forma for Riley & Everest acquisitions

7 Total Solutions Approach Implants Total Solutions Instruments Cases Products Services Core Competencies Quality

8 Multiple Growth Drivers Orthopedic Industry Up-Selling Outsourcing Trends Partnership Trading Multiple Growth Drivers Cross-Selling New Markets/ Customers New Technologies MIS/IGS/CAS

9 Competitive Advantage Size & Capability Quality/Regulatory Expertise Global Resources Competitive Advantage Sales Force Presence Comprehensive Products & Services Established Business Diverse Customer Base

10 Advantages Offered to Customers Accelerates time to market Rationalization of product/service providers Partner of Choice Efficient supply-chain management Complexity of manufacturing medical devices Adoption of Symmetry proprietary products and design & development services Customer focus on Return on Invested Capital Most of Symmetry s orthopedic customers are increasingly relying on outsourcing

11 Our Target Markets Are Large and Growing OUR CORE MARKETS Arthroscopy Oral Maxillofacial Osteobiologics Power Instruments Reconstructive Spinal Sports Medicine Trauma Wound Care $17B Orthopedics $19B In Vitro Diagnostics $26B Diagnostic Imaging $16B Dialysis $11B Dental $9B Cardiology $18B Ophthalmology $8B Total Medical Technology Market: $220B

12 We Continue to Build Our Diverse Customer Base Reconstructive Trauma & Spine New Aesculap Existing Pioneer Endoscopy and Other YTD Biologics Dental Cardiology

13 Investing in Future Growth WARSAW, IN Trauma / spine expansion Knee Instrument expansion New Design & Development Center LANSING, MI New Design & Development Center Implant Finishing Center MONSEY, NY Everest Metal CORK, IRELAND Everest Metal Intl SHEFFIELD, UK Implants Adjacent land purchase LILLE, FRANCE Case expansion MEMPHIS, TN New Design & Development Center MANCHESTER, NH Case expansion AUBURN, ME Riley Cases CHELTENHAM, UK Instrument expansion CORGEMONT, SWITZERLAND Riley Cases

14 Strategic Initiatives Orthopedic More global Asia, Switzerland & Ireland More IP / design opened DDC Acquisitions IP / global / niche - Everest Focus spine / niche markets Medical Device Markets Market presence / capability creates opportunities Acquisitions Riley / Everest Design support Niches Aerospace expansion

15 Increase Global Presence Rationale Access low cost manufacturing geographies Expand footprint to strategically locate near customers Improve customer service Recent Initiatives Asia Switzerland Ireland New Jersey Access lower cost engineering talent Potential tax advantages 17 Locations World Wide

16 Improve Design and Development Capabilities Rationale Key differentiator versus competitors Opportunity to improve cross-selling, upselling and co-development Total Solutions logistics Sell design services New market initiatives Recent Initiatives Increase patents to over 80 Expanded sales offering of design services Re-focusing on Symmetry s own product development Implementing Service Centers to provide local support to customers New Service Hotline 24/7 and 365 days a year New DDC Opened in Warsaw 2006

17 Target Non-Reconstructive Markets Significant growth opportunities Complementary to current operating infrastructure Non-Reconstructive Target Markets Spine Dental Aerospace Revenue By Market Pow er Instrum ents Pow er Cardiology Manual Instrum ents De ntal Spine Endoscopy Arthroscopy Trauma Trauma a Arthroscopy Reconstructive

18 Acquisitions Support strategic intent Easily integrated & operational synergies Value added IP Financially justified

19 Riley Acquisition Completed on May 3, 2006 Broadens and strengthens our product offering Solid intellectual property portfolio with 23 patents, 11 trademarks Increases our penetration in other medical device markets like spine and endoscopy Expands our growing international presence Acquired for $45 million in cash Revenue ~$22M

20 Everest Acquisition Completed August 31, 2006 Expands our implant finishing business Strengthens our local presence near Symmetry Medical customers Helps strengthen our competitive advantage as a Total Solutions provider Acquired for $8.8 million in cash, subject to adjustments for contingent consideration of $1.4 million Revenue ~$7M

21 Financial Overview

22 Financial Trends Revenue Operating Income EPS $264 $253 $260 $51 $38 $36 $38 $0.92 $205 $23 $0.66 $0.70 $158 $0.46 $0.35 (a) E 2006E (a) (b) E 2006E (a) (b) E 2006E (a) 2003 pro forma adjustments gives effect to the Mettis acquisition as if it occurred at the beginning of fiscal year 2003 as detailed in 12/9/04 S-1 (b) Excludes $5.4 million, after tax charge for loss of debt extinguishment as shown on non-gaap EPS reconciliation

23 Trends Impacting Performance from 2005 to 2006 Revenue decline concentrated at top customers Inventory pullback at top customers Scaled back launches (regional versus national) Maintaining market share Prices are flat Product mix is unfavorable Scale efficiencies post recent facility expansion Continue to invest in business for future growth 2006 pullback primarily due to a temporary correction in the industry. Symmetry is well positioned as market rebounds

24 Financial Performance ($ in millions) Total Year 1H 06 Q Growth 2006 Growth 2006 Growth Revenue $264 28% $195-3% $61-10% Gross Profit $79 30% $51-16% $14-31% Gross Margin 29.8% 26.1% 22.5% Operating Income $51 35% $30-25% $6-49% % of Revenue 19.3% 15.1% 10.3% Net Income (a) $32 86% $19-22% $3-64% EPS (a) $ % $ % $ % (a) 2004 pro forma adjustments exclude certain one-time charges as shown in non-gaap EPS reconciliation

25 Summary Capitalization ($ in millions) 3Q 06 Cash and Cash Equivalents 9.6 Long-Term Debt $40MM Revolving Credit Facility -- Term Loan Facility 64.2 Capital Lease Obligations 9.0 Total Long-Term Debt 73.2 Shareholder s Equity Total Capitalization Debt / Equity Ratio 26%

26 Financial Goals and Objectives Long-Term Financial Goals Revenue Growth 12% 15% Operating Income Margin Expansion bps p.a. Operating Income Growth 17% + Net Income Growth 18% +

27 Non-GAAP EPS Reconciliation $ Million Fiscal Year Ended Jan. 1, As Adjusted Net Income: 2005 Net Income After Preferred Dividends 2.7 Loss on Debt Extinguishment, Net of Taxes 5.4 As Adjusted - Net Income 8.1 Weighted Average Basic 16.9 W eighted Average Fully Diluted 17.8 As Adjusted Net Income Per Share-Diluted: Net Income After Preferred Dividends 0.15 Loss on Debt Extinguishment, Net of Taxes 0.30 As Adjusted - Net Income 0.46 Note: Adjusted results should not be considered indicative of actual results that could have been achieved in any prior period and do not purport to be indicative of results as of any future period. T hese adjusted earnings per share figures are not indicative of future earnings per share due to; among other things, the increase in the number of shares outstanding in connection withour initial public offering in December 2004 and the dilutive impact of such increase on earnings per share.

28 The Symmetry Story World s largest provider to major orthopedic companies Attractive business model Significant advantages versus competition Multiple avenues for growth Strong and increasing global presence Strong free cash flow generator Deep and experienced management team

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