One of Seymour Sarason’s most original and important works was his book, The Creation of Settings and the Future Societies (Sarason, 1972). In it, he offered numerous insights about what goes wrong when “two or more people come together in new relationships over a sustained period of time in order to achieve certain goals.” His hope in writing the book was that greater knowledge and understanding of the setting-creation process would help people create more effective and humane settings and prevent “organizational craziness.” This article first describes how and why Sarason became interested in the problem. It then summarizes a few of his most important insights about the process. The article concludes by considering the impact and legacy of Sarason’s work on the creation of settings.