(99m)Tc is currently produced by an aging fleet of nuclear reactors, which require enriched uranium and generate nuclear waste. We report the development of a comprehensive solution to produce (99m)Tc in sufficient quantities to supply a large urban area using a single medical cyclotron. A new target system was designed for (99m)Tc production. Target plates made of tantalum were coated with a layer of (100)Mo by electrophoretic deposition followed by high-temperature sintering. The targets were irradiated with 18-MeV protons for up to 6 h, using a medical cyclotron. The targets were automatically retrieved and dissolved in 30% H2O2. (99m)Tc was purified by solid-phase extraction or biphasic exchange chromatography. Between 1.04 and 1.5 g of (100)Mo were deposited on the tantalum plates. After high-temperature sintering, the (100)Mo formed a hard, adherent layer that bonded well with the backing surface. The targets were irradiated for 1-6.9 h at 20-240 μA of proton beam current, producing up to 348 GBq (9.4 Ci) of (99m)Tc. The resulting pertechnetate passed all standard quality control procedures and could be used to reconstitute typical anionic, cationic, and neutral technetium radiopharmaceutical kits. The direct production of (99m)Tc via proton bombardment of (100)Mo can be practically achieved in high yields using conventional medical cyclotrons. With some modifications of existing cyclotron infrastructure, this approach can be used to implement a decentralized medical isotope production model. This method eliminates the need for enriched uranium and the radioactive waste associated with the processing of uranium targets.