This paper reviews the problems of project management as reported by 1,879 individuals employed in the construction, manufacturing, process, and service industries in North-West Europe over 23 years. Data obtained by a written questionnaire confirms that organizational relationships need the most attention. The data exhibits no trends over the 23 years. It indicates that many of the problems of project management are “institutional”; in other words, they are due to organizational cultures rather than inherent in project work. The evidence supports the view that poor discipline at the front-end of projects results in too much “fire-fighting” in project execution to overcome problems that could have been prevented. Prevention of these institutional problems requires action at the level of corporate governance, above the level of project management.