This research paper aims to provide insights into the impact generated by the introduction of Agile methodologies in Romanian industrial environments which used to work exclusively with Waterfall methodologies for the delivery of IT products and services. Through this study, the authors aim to uncover perceptions provided by knowledge workers working in the area of IT Service Management who have experienced first-hand this transition in ways of working from Waterfall to Agile, followed by suggestions on how to improve the process of integrating new elements in future transition activities. In order to achieve this aim, a qualitative research exercise has been performed, by conducting interviews with experienced knowledge workers who carry out IT Service Management activities. The results of the research present both breakthrough and setback points with this activity. Breakthrough points focus on the perception of knowledge workers having higher levels of autonomy and ownership of daily activities and dependency on ITIL/ISO process alignment for achieving auditing requirements. Setback points include the need for guidelines availability to ensure better integration between Waterfall and Agile elements, design of metrics to reflect Agile elements integration, and optimisation of tools usage to avoid redundant activities. Following this research, the authors recommend development of more focused research in the area of ITSM activities, as this is an untapped source of improvement for organisations. These findings help contribute to a better understanding of the evolution of IT Service Management processes and builds a basis for further research on change initiatives of IT processes.