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To accelerate discovery and achieve meaningful progress in biomedical research requires a high tolerance for risk and the ability to pivot quickly. Science philanthropies play a unique role by providing both catalytic capital and stopgap funding to move ideas from early-stage research to therapeutic development—through seed funding, workforce support, and bold, high-impact bets. Yet one of the greatest challenges funders face is knowing how to plan for and adapt to scientific, financial, partnership risks while maximizing the impact of their investments. This roundtable will examine risks across the biomedical research ecosystem and the strategies philanthropists use to manage them effectively. Through expert insights, peer dialogue, and real-world examples, participants will share approaches for recognizing risk, making informed pivots, and sustaining progress as scientific and funding landscapes evolve.