The use of fouling factors in heat exchanger design and the lack of appreciation of fouling in traditional pinch approaches have often resulted in crude preheat networks that are subject to extensive fouling. The development of thermal and pressure drop models for crude oil fouling has allowed its effects to be quantified so that techno-economic analyses can be performed and design options compared. The application of these fouling models is described here on two levels: the assessment of increasing heat recovery in stream matches (e.g., by adding extra area to exchangers) and the design of a complete network using the Modified Temperature Field Plot. Application to a refinery case study showed that, at both the exchanger and network levels, designing for maximum heat recovery (e.g., using traditional pinch approaches) results in a less efficient system over time due to fouling effects.