Real-time and continuous monitoring of high value goods can considerably improve the reliability and effectiveness of supply chains. Wireless Sensor Networks (WSN) offer technical capabilities for continuous sense and respond capabilities. WSN offer complementary advantages over the use of Radio Frequency Identification (RFID) in supply chains. Still, WSN have not been massively adopted. While some success stories on the use of RFID in supply chains have appeared, little research is available that studies the slow adoption of WSN. This paper presents results of a qualitative case study of the ongoing adoption of WSN in a Pharmaceutical Cold Chain to prevent loss of high value shipments. Based on interviews with various actors in the supply chain, benefits and barriers that impact the adoption process are identified. Using a process view and inter-organizational adoption model, the complex relationships between adoption factors are analyzed. The results show that WSN can effectively improve process quality and reduce waste in the cold chain. However, careful attention needs to be paid to managing the various interconnected factors that may support or hinder adoption. The study demonstrates that a process view contributes to understanding the adoption process. Moreover, an inter-organizational view to the adoption process is needed to successfully introduce WSN in the Pharmaceutical Cold Chain.