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Expansion of the offshore UK wind energy sector has stimulated renewed interest in the response of piles to lateral and moment loads. This paper compares the state of the art in foundation design with current industry trends in offshore wind turbine construction. The historical evolution of pile design for lateral loading is described in detail, focusing on the American Petroleum Institute guidelines used by the offshore sector. The limitations of these design codes are discussed in light of the specific requirements for the wind sector. Recent research efforts attempting to bridge the gap between practice and industry are highlighted and further research needs are identified.