**Exhibit 99.1**

** **

**Symmetry Medical Inc.2004 Employee Stock Purchase Plan**

Reportof Independent Registered Public Accounting Firm****andFinancial Statements

December31, 2006 and 2005

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**Report of Independent RegisteredPublic Accounting Firm**

Compensation Committee of the Board of Directors

Symmetry Medical Inc.

Warsaw, Indiana

We have audited the accompanying statements offinancial condition of the Symmetry Medical Inc. 2004 Employee Stock PurchasePlan as of December 31, 2006 and 2005, and the related statements of income andchanges in plan equity for the years then ended.  These financial statements are theresponsibility of the Plan’s management. Our responsibility is to express an opinion on these financialstatements based on our audits.

We conducted our audits in accordance with thestandards of the Public Company Accounting Oversight Board (UnitedStates).  Those standards require that weplan and perform the audit to obtain reasonable assurance about whether the financialstatements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting theamounts and disclosures in the financial statements.  An audit also includes assessing the accountingprinciples used and significant estimates made by management, as well asevaluating the overall financial statement presentation.  We believe that our audits provide areasonable basis for our opinion.

In our opinion, the financial statements referred toabove present fairly, in all material respects, the financial condition of theSymmetry Medical Inc. 2004 Employee Stock Purchase Plan as of December 31,2006 and 2005, and the results of its operations for the years then ended, inconformity with accounting principles generally accepted in the United Statesof America.

Federal EmployerIdentification Number:  44-0160260

Fort Wayne, Indiana

March 7, 2007

/s/  BKD, LLP

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**Symmetry Medical Inc. 2004Employee Stock Purchase Plan**

**Statements of Financial Condition**

**December 31, 2006 and 2005**

** **
| ** **      | ** ** | **2006** | ** ** | **2005** | ** ** |
|-----------------|------------|----------|------------|----------|------------|
| **Assets**      |       |     |       |     |       |
| Cash            |       | $        | 2,040      |     | $          | 5,177 |   |
|            |       |     |       |     |       |
| **Plan Equity** |       | $        | 2,040      |     | $          | 5,177 |   |

 

**Symmetry Medical Inc. 2004Employee Stock Purchase Plan**

**Statements of Income and Changesin Plan Equity**

**YearsEnded December 31, 2006 and 2005**
| ** **                                                     | ** ** | **2006** | ** ** | **2005** | ** ** |
|----------------------------------------------------------------|------------|----------|------------|----------|------------|
| **Additions**                                                  |       |     |       |     |       |
| Participant contributions                                      |       | $        | 246,112    |     | $          | 847,498 |   |
|                                                           |       |     |       |     |       |
| **Reductions**                                                 |       |     |       |     |       |
| Withdrawals and terminations paid in cash                      |       | (550     | )          | (8,680   | )          |
|                                                           |       |     |       |     |       |
| Purchase and distribution of stock (17,823 and  60,793 shares) |       | (248,699 | )          | (833,641 | )          |
|                                                           |       |     |       |     |       |
|                                                           |       | (249,249 | )          | (842,321 | )          |
|                                                           |       |     |       |     |       |
| Income (loss) and changes in plan equity for the  year         |       | (3,137   | )          | 5,177    |       |
|                                                           |       |     |       |     |       |
| Plan equity, beginning of year                                 |       | 5,177    |       | 0        |       |
|                                                           |       |     |       |     |       |
| Plan equity, end  of year                                      |       | $        | 2,040      |     | $          | 5,177 |   |

 

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**Note1:**                                      Summaryof Significant Accounting Policies

***Plan Administration***

The CompensationCommittee (Committee) of the Board of Directors of Symmetry Medical Inc.(Company) administers the Plan.  TheCommittee has the authority to interpret the Plan, to prescribe, amend andrescind rules and regulations relating to the Plan, and to make all otherdeterminations necessary or advisable for the administration of the Plan.  The administration, interpretation orapplication of the Plan by the Committee will be final, conclusive and bindingupon all persons.  The Company will bearthe expenses of administering the Plan, except that any stamp duties ortransfer taxes applicable to participation in the Plan may be charged to theaccounts of the participants.

The purpose of the Planis to provide eligible employees of the Company the opportunity to purchase theCompany’s common stock through semiannual offerings financed by payrolldeductions.  Participants may elect tohave up to 10% of compensation deducted from their pay annually to purchaseshares.  Participant contributions forany plan year may not, in the aggregate, exceed an amount that allows theparticipant to purchase Company stock with a collective fair market value ofmore than $25,000 on the date of the grant to purchase Company stock.

***Organization***

The Plan was originallyadopted by the Board of Directors on December 2, 2004.  A total of 600,000 shares of common stockhave been reserved for issuance under the Plan. The number of shares reserved for issuance will be increased each yearuntil 2014 by the lowest of 100,000 shares, 1% of all shares outstanding at theend of the previous year, or a lower amount determined by the Board ofDirectors.  The shares of common stockissued under the Plan may be newly issued shares or shares reacquired inprivate transactions or open market purchases. In 2005, all shares issued under the Plan were newly issued.  Shares are issued to participants in theirname, and the shares are not included in Plan assets.

The Plan began enrollingparticipants on March 28, 2005, in an initial enrollment period that endedApril 8, 2005.  During the initialenrollment period, participants were permitted to purchase shares with a lumpsum contribution not to exceed 10% of eligible compensation participants havereceived or expected to receive during the six-month period ended June 30, 2005.  Participants enrolled prior to June 30, 2005,were able to purchase stock at 85% of the lower of the Company’s initial publicoffering price of $15 per share or the closing price at June 30, 2005, asquoted on the New York Stock Exchange. Subsequent to June 30, 2005, participants can purchase shares at 95% ofthe closing on the last day of each exercise period.

In 2005, the Companyissued 50,468 shares at $12.75 per share and 10,325 shares at $18.42 per sharein June and December, respectively, to participants in the Plan.  As of December 31, 2005, the Plan had 249participants.

In 2006, the Companyissued 9,740 shares at $14.63 per share and 8,083 shares at $13.139 per sharein June and December, respectively, to participants in the Plan.  As of December 31, 2006, the total number ofparticipants with balances is 423 of which 165 participants are activelycontributing to the Plan.

**Note2:**                                      IncomeTax Status

The Plan is not and willnot be qualified under Section 401(a) of the Internal Revenue Code of 1986, asamended (Code).  The Plan is intended toqualify as an employee stock purchase plan under

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Section 423 of theCode.  Consequently, the differencebetween the purchase price and the fair market value of the stock purchaseunder the Plan is not includable in the participant’s gross income for federalincome tax purposes, unless a disqualifying distribution occurs.

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