This paper reviews the technical ecosystem of Gate, an open-source Monte Carlo simulator for medical physics. Based on the shoulders of Geant4, the principal modules (geometry, physics, scorers) are described together with brief descriptions of some key concepts (Volume, Actors, Digitizer). The main source code repositories are described together with the automated compilation and tests processes (Continuous Integration). We then described how the OpenGATE collaboration managed the collaborative development of about one hundred developers during almost 20 years. The impact of Gate on medical physics and cancer research is then summarized. Finally, future development perspectives are indicated.