As we tend towards more electric power distribution networks including distributed energy resources (DERs) which are increasing in terms of power capability and requirements. The design of the electric ship power and distribution system follows suit with the added challenge of achieving smaller footprint on islanded power distribution networks. These challenges are namely, equipment and conductor sizes, including the associated infrastructure such as interconnecting power cables, copper busbars and the associated supporting installation equipment including cable trays and ladders. Additionally, noise & vibration, shock, and other environmental factors along with the associated forces during fault events such as short circuits and the insulation challenges particularly on MV system must be considered. The selection criteria for using MV or LV technology is therefore non-trivial, and not limited to only the best technologies available at the time of consideration, but, to other considerations including cost, technology readiness level (TRL) of equipment, power density and feasibility of installation and integration among some of the overall considerations. A clear understanding of the advantages & disadvantages of LV and MV technology leads to the design of better systems that can future-proof the capability of the electric grid and enables the use of clean energy at larger scale using sources such as hydrogen or similar fuel cells and batteries, which are modular and well suited for power stages inherent in converter technologies. A novel solution using an LV DC to / from MV DC converter topology patented by GE-PC, allowing greater flexibility in MV-DC systems, while maintaining a smaller footprint is presented in this paper. This paper aims to examine the various factors involved in specifying an electrical power system with supporting power equipment holistically and how these factors can affect the decision based on the use of MV or LV technologies.