Emerging neurotechnologies raise important governance questions related to, for example, dual use, brain data privacy, and manipulation of personal autonomy. Although many public sector research initiatives have implemented measures to address these issues, similar systematic measures in the private sector have yet to emerge. This gap is critical, as neurotech innovation today is largely driven by a set of companies that are subject to growing public scrutiny1,2,3,4,5. Here we detail lessons, emerging practices and open questions for responsible innovation in the private sector that are the result of three years of policy deliberations that began with a 2018 conference in Shanghai convened by the Organization for Economic Co-operation and Development (OECD) and led to the release of the “OECD Recommendation on Responsible Innovation in Neurotechnology” last year6. The principles therein cover opportunities and challenges for better innovation practices in company settings—including the use of ethics advisory boards, company-level principles, and ethics-by-design approaches—with broad relevance beyond neurotech to digital medicine and corporate R&D activities in today’s era of ‘tech-lash’. We argue that it is time for a radical shift in the conversation about governance of emerging neurotech: effective governance must focus on the private sector as a central actor early on—before trajectories are locked in and scaling takes off—and requires a new set of policy perspectives and collaborative tools to do so. These tools must complement existing efforts in public-sector research ethics, post hoc product regulation and corporate social responsibility. They must also reflect the growing recognition that we cannot rely on industry self-regulation alone to steer innovation activity in socially desirable directions.