This paper identifies some of the causes of imperfections in real pile foundations and then examines their possible effects on pile behavior. The imperfections considered arise from two main sources, natural imperfections caused by the geological circumstances and imperfections related to the construction of the piles. In each case, single piles are considered first, and then pile groups are addressed separately. Case histories are presented to illustrate the effects on pile performance which are predicted by theoretical analyses. The analyses with which these examinations are carried out will still inevitably involve some degree of idealization, but at least attempt to incorporate the key “nonideal” aspects. The paper also discusses the particular problems involved in investigating and analyzing underperforming pile foundations and reviews some methods by which the consequences of imperfections may be overcome or ameliorated.