Abstract. Medicane Ianos in September 2020 was one of the strongest medicanes observed in the last 25 years. It was, like other medicanes, a very intense cyclone evolving from a baroclinic mid-latitude low into a tropical-like cyclone with an axisymmetric warm core. The dynamical elements necessary to improve the predictability of Ianos are explored with the use of simulations with the Met Office Unified Model (MetUM) at 2.2 km grid spacing for five different initialisation times, from 4 to 2 d before Ianos's landfall. Simulations are also performed with the sea surface temperature (SST) uniformly increased and decreased by 2 K from analysis to explore the impact of enhanced and reduced sea surface fluxes on Ianos's evolution. All the simulations with +2 K SST are able to simulate Medicane Ianos, albeit too intensely. The simulations with control SST initialised at the two earliest times fail to capture intense preceding precipitation events at the right locations and the subsequent development of Ianos. Amongst the simulations with −2 K SST, only the one initialised at the latest time develops the medicane. Links between sea surface fluxes and upper-level baroclinic processes are investigated. We find three elements that are important for Ianos's development. First, an area of low-valued potential vorticity (PV), termed a “low-PV bubble”, formed within a trough above where Ianos developed; diabatic heating associated with a preceding precipitation event triggered a balanced divergent flow in the upper levels, which contributed to the creation and maintenance of this low-PV bubble as shown by results from a semi-geostrophic inversion tool. Second, a quasi-geostrophic ascent was forced by middle and upper levels during Ianos's cyclogenesis. It is partially associated with the geostrophic vorticity advection, which is enhanced by the growth and advection of the low-PV bubble. Third, diabatic heating dominated by deep convection formed a vertical PV tower during Ianos's intensification and continued to produce diabatically induced divergent outflow aloft, thus sustaining Ianos’s development. Simulations missing any of these three elements do not develop Medicane Ianos. Our results imply the novel finding that preceding convection was essential for the subsequent development of Ianos, highlighting the importance of the interactions between near-surface small-scale diabatic processes and the upper-level quasi-geostrophic flow. A warmer SST strengthens the processes and thus enables Ianos to be predicted in simulations initiated at the earlier times.