The article presents a conceptual framework and a coherent method for design in an organizational context within the participatory design tradition. The MUST method has been developed throughout 10 projects in Danish and American organizations, and it has recently been evaluated and adopted by 3 Danish organizations. The method is based on thorough participation with users and managers, and it combines the use of ethnographic techniques and intervention. The article describes the application area and perspective of the method, presents 6 general principles on which the method is based, and describes 5 main activities providing a stepwise decision-making process in the overall design process. Each of the main activities is illustrated by an example taken from our last project. The article concludes by summing up the main points.