In this interview, Maria Grazia Felisi, Quality Assurance Head and Internal Auditor in Clinical Validation at Biopharmaceutical Findings (CVBF), an Italian CRO, discusses the conduction of multicenter and multinational clinical trials within the context of rare diseases. She provides an overview of the reasons for conducting clinical trials outside Europe and addresses the main challenges encountered, illustrating a practical case in which CVBF was directly involved.