This study aims to design and optimize an organic Rankine cycle (ORC) and radial inflow turbine to recover waste heat from a polymer exchange membrane (PEM) fuel cell. ORCs can take advantage of low-quality waste heat sources. Developments in this area have seen previously unusable, small waste heat sources become available for exploitation. Hydrogen PEM fuel cells operate at low temperatures (70 °C) and are in used in a range of applications, for example, as a balancing or backup power source in renewable hydrogen plants. The efficiency of an ORC is significantly affected by the source temperature and the efficiency of the expander. In this case, a radial inflow turbine was selected due to the high efficiency in ORCs with high density fluids. Small scale radial inflow turbines are of particular interest for improving the efficiency of small-scale low temperature cycles. Turbines generally have higher efficiency than positive displacement expanders, which are typically used. In this study, the turbine design from the mean-line analysis is also validated against the computational fluid dynamic (CFD) simulations conducted on the optimized machine. For the fuel cell investigated in this study, with a 5 kW electrical output, a potential additional 0.7 kW could be generated through the use of the ORC. The ORC’s output represents a possible 14% increase in performance over the fuel cell without waste heat recovery (WHR).