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In ultra-low data rate wireless sensor networks (WSNs) waking up just to listen to a beacon every superframe can be a major waste of energy. This study introduces MedMAC, a medium access protocol for ultra-low data rate WSNs that achieves significant energy efficiency through a novel synchronisation mechanism. The new draft IEEE 802.15.6 standard for body area networks includes a sub-class of applications such as medical implantable devices and long-term micro miniature sensors with ultra-low power requirements. It will be desirable for these devices to have 10 years or more of operation between battery changes, or to have average current requirements matched to energy harvesting technology. Simulation results are presented to show that the MedMAC allows nodes to maintain synchronisation to the network while sleeping through many beacons with a significant increase in energy efficiency during periods of particularly low data transfer. Results from a comparative analysis of MedMAC and IEEE 802.15.6 MAC show that MedMAC has superior efficiency with energy savings of between 25 and 87 for the presented scenarios. © 2011 The Institution of Engineering and Technology.