Within a decade after graduating from Rice University, David Tsao ’17 transformed a startup based on a simple diagnostic blood test into a unicorn enterprise that touches millions of lives worldwide.
In recognition of his contributions to the industry and society, the George R. Brown School of Engineering and Computing and the Rice Engineering Alumni board have selected Tsao as the recipient of the Outstanding Young Engineering Alumni Award, which honors accomplishments of an alumnus under the age of 40.
Tsao is the Chief Technology Officer and co-founder of BillionToOne, a next-generation molecular diagnostics company with a mission to create powerful and accurate tests that are accessible to all. Under his leadership, the company has commercialized first-in-kind diagnostics for prenatal screening and oncology, processed more than one million clinical tests, and grown to over $300 million in annual revenue.
“David Tsao’s leadership in building a unicorn enterprise serves as an inspiration for our students and a shining example of the innovation driven by our alumni,” said Luay Nakhleh, William and Stephanie Sick Dean of the School of Engineering and Computing. “His work reflects our school’s commitment to translating bold ideas into real-world solutions that serve humanity.”
BillionToOne has redefined possibilities in noninvasive prenatal testing (NIPT). With the commercial launch in 2019, it introduced UNITY as the first and only prenatal test that can assess fetal risk for common recessive conditions using only a maternal blood sample, addressing a significant gap in the traditional NIPT market.
“We thought we could create a test looking at the fetal DNA to determine if the baby has conditions such as sickle cell disease and cystic fibrosis, and we built the company around technology that measures the fetal genotype using only the mom's blood,” said Tsao.
There are three billion base pairs in the human genome, and the company’s NIPT technology can identify the single base pair that is different by testing a small amount of fetal DNA present in the mother’s blood stream. Once the disease is detected in the womb, physicians can begin treating the conditions before the baby is born, reducing prenatal and neonatal complications.
“There have been multiple studies of moms who have a baby diagnosed with cystic fibrosis because of our test,” said Tsao. “Because there are now effective cystic fibrosis therapies, moms can take a pill to treat the developing baby, and babies are now being delivered with no complications from cystic fibrosis.”
In 2025, BillionToOne surpassed one million UNITY tests and expanded Medicare access—a significant step forward for accessible, equitable prenatal care.
Tsao’s bold ideas have roots at Rice University’s Department of Bioengineering, where Tsao received his doctoral degree in bioengineering and biomedical engineering.
“Working in Michael Diehl’s lab at Rice gave me a solid foundation for solving technical problems at BillionToOne,” said Tsao. “When developing our technologies to measure the fetal genotype, I applied the robust skill set I gained at Rice to make sure all the technical aspects were optimized for the problems we face.”
BilliontoOne has adapted its DNA technology for advanced cancer tests, such as detecting tumor DNA and showing and monitoring mutations in metastatic cancer. Its Northstar Response technology uses a simple blood test to detect signs that a cancer is progressing earlier than with standard imaging, enabling more effective treatment.
“What we’ve been able to accomplish at BillionToOne wouldn’t have been possible without my experience at Rice,” said Tsao. “I feel honored to receive the Outstanding Young Alumni Award, and it reflects so strongly back on the training and environment that Rice offers.”
Tsao will be formally honored at the George R. Brown School of Engineering and Computing Alumni Awards Celebration on October 22, 2026.