This document discusses the primary causes of premature rotating machinery failures due to misalignment. It finds that 50-70% of such failures are misalignment-related. While alignment methods and tools have improved, misalignment still frequently occurs due to a lack of understanding machine concepts, misconceptions about coupling flexibility, and failure to address all potential sources of misalignment beyond just achieving tolerance specifications. These sources include issues like pipe strain, thermal growth, bent shafts, soft foot, poor foundations, and excessive coupling runout. Addressing misalignment requires analyzing its various potential root causes.