This paper suggests that there are five problems with contingency theory, ranging from a simple lack of clarity in its theoretical statements to more subtle issues such as the embedding of symmetrical and nonmonotonic assumptions in the theoretical arguments. Starting from Galbraith's (1973) contingency theory about organizing for effectiveness, several traditional contingency hypothesis were tested along with more precise hypotheses developed from knowledge of the five problems with contingency theory. Data were drawn from a study of organizational effectiveness in acute care hospital operating room suites. Although traditional contingency notions were not supported by the data, the more precise hypotheses received stronger empirical support. The study data suggest that relationships between technology, structure, and organizational effectiveness are more complicated than contingency theory now assumes. The paper concludes by suggesting formulation of a contingency theory of organizational effectiveness that includes interactive, nonmonotonic, and symmetrical arguments.