Abstract This paper deals with collaborative terminological activities in the biomedical field. Efficient communication based on uniform language use is a prerequisite for safe and cost-efficient patient care. Terminological consistency and standardization are therefore central issues in healthcare with high societal relevance. The objectives of this contribution are (1) to show how actors from different disciplines and institutions are involved in the standardization of medical terminology and electronic terminology systems; (2) to describe how translation-oriented terminological principles affect the translation of the Systematic Nomenclature of Medicine – Clinical Terms (SNOMED CT). The challenges of this approach will be discussed and some suggestions for its further development will be made.