Failure mode and effect analysis (FMEA) is an important method for designing and prioritising preventive maintenance activities and is often used as the basis for preventive maintenance planning. Although FMEA was studied extensively, most of the published work so far covers FMEA concept design. Little detailed comparison to industrial practice regarding the application of FMEA can be found in the literature, which is the contribution of this study. This paper summarises the main descriptions and assumptions found in the literature on FMEA into six postulates, and compares the postulates to industrial practice. This was done in a multiple case study conducted at six companies in the process industry. Some postulates were supported by empirical evidence, whereas for others, limited or no support could be found. The results suggest a fundamental problem in the FMEA procedure, namely, the reliance upon expert judgement in general and the reliance upon design engineering expertise for keeping the FMEA up-to-date in particular. Also, a number of operational and information management problems that companies suffer from when conducting an FMEA were identified. Practitioners can use this paper to assess their potential for implementing FMEA and to learn from the insight into the identified pitfalls. Researchers can use the findings to guide further work on improving and developing the FMEA procedures.