VistaMed said it is investing €10m in a new research and development plant in Carrick-on-Shannon.
Manufacturing at the site will also be expanded.
VistaMed makes catheters for medical use. The new roles will take the numbers employed by the company in Co Leitrim to 525.
Recruitment has started already and VistaMed said all the positions are expected to be filled by the end of 2018.
Jobs Minister Mary Mitchell O’Connor said the latest expansion of the home-grown company is evidence that a rural county such as Leitrim can be home to successful international companies.
“To announce 200 jobs for an Irish-owned, highly innovative, global supplier of medical technology out of County Leitrim, sums up why we can be ambitious — indeed, must be ambitious — in our plans for regional development and job creation,” she added. The company was founded in 1999.
Meanwhile, Harvey Norman has announced it is to create 50 jobs with the opening of a new store in Airton Road retail park in Tallaght.
Construction is due to begin in October and will see five smaller retail units in the park merged. The new store location sees the number of Harvey Norman stores in the Republic grow to 13.
Harvey Norman said it planned to invest in the region of €6m in its latest project.
Also in Dublin, Camile Thai Kitchen, the Thai food restaurant delivery business announced it will open three new branches in Ireland, in Stillorgan and Artane in Dublin and in Sligo town before the end of the year, creating 100 jobs.
The brand currently has 10 branches in Dublin.