Industrial accidents and failures involving machinery were analysed by appropriate literature and loss records of insurers. While serious machinery accidents have decreased for many types of machinery, thanks to developments in technologies and safety engineering together with more advanced user practices, there are areas where surprising increases of machine-related fatalities still occur. Traditional machinery accidents with grinding tools, cranes, winches, etc., seem to recur often in connection with reorganization of work in industry. Losses due to machinery breakdown failures are dominated by power generation, i.e. boilers and pressure vessels, turbines and electrical machinery, but mainly there are no casualties. However, prevention of failures is of crucial importance in order to reduce the potential of catastrophic incidents. Both for failures and casualties, indications of epidemic-type patterns of losses are found, which too often are encountered, surprisingly, in industry and among insurers alike. Prevention needs to be focused on the root causes of accident processes, but this is an extremely difficult task against the ever-increasing pace of changes in production and organizational structures of work.