When key account management (KAM) programmes are created, they do not appear in a vacuum. Rather, they are developed in existing organizations and as a consequence the question arises of how to align the newly implemented KAM units within the host organizations. We propose using Lawrence and Lorsch's (1967a&b) differentiation concept and the concept of frame alignment (Goffman, 1974; Snow, Rochford, Worden, & Benford, 1986) to assess how much a KAM unit is actually differentiated and how to improve alignment. In a case study, we then describe the creation process of a KAM unit at Waters IS, a company specialising in water treatment. Based on a discussion of the theoretical concepts and the case situation, we suggest an approach to the assessment and management of alignment issues for KAM units.