Analyses of load settlement behavior for pile groups must consider the interaction of nearby piles. In small pile groups, the key factor for evaluating load-settlement behavior is single-pile stiffness, but when analyzing large pile groups and piled rafts, the importance of induced settlements due to neighboring piles increases. This paper reviews the most commonly used approaches that consider the interaction between piles and notes some aspects that can result in important differences in foundation settlement predictions. Topics including soil heterogeneity, the presence of other piles, and large pile groups are presented using both the conventional approach and finite element method analysis, showing that for large piled foundations, such aspects can result in considerable differences.