High power isolated DC-DC converters are likely to provide solutions for many technical challenges associated with power density, efficiency and reliability in potential applications such as offshore wind farms, inter-connection of DC grids, MVDC in data centers and in future solid state transformer applications. The high power medium frequency transformer (HPMFT) is one of the key elements of such a converter to realize the voltage adaption, isolation requirements, as well as high power density. This paper describes a design and optimization methodology taking into account the loss calculation, isolation requirements and thermal management. Incorporating this design methodology, an optimization process with a wide range of parameter variations is applied on a 50 kW, 1 / 3 kV, 5 kHz transformer to find the highest power density while the efficiency, isolation, thermal and leakage inductance requirements are all met. The optimized transformers are then manufactured and will be presented in this paper.