Semiconductor laser diodes are compact, efficient and reliable sources of laser light and 25 W fiber coupled systems developed by Diomed have been in clinical use for over three years. For certain applications, particularly in the treatment of benign prostatic hyperplasia and flexible endoscopy, higher powers are desirable. In these applications the use of flexible optical fibers of no more than 600 micrometers core diameter is essential for compatibility with most commercial delivery fibers and instrumentation. A high power 60 W diode laser system for driving these small core fibers has been developed. The design requirements for medical applications are analyzed and system performance and results of use in gastroenterology and urology with small core fibers will be presented.