The thrust bearing duty in a pump-turbine generator can be quite arduous, since the pad support system must be symmetrical about the center of the pad, yet the oil-film must converge adequately for either direction of rotation. Special care must be taken with large machines since the thermal and elastic deformation of the pads will increase nonlinearly with size B of the pad, for example, as B2 when thermal deformation is considered. However from first principles, the thickness of the oil film will increase with only the square root of size B½. Poorly shaped films can develop when a design standard is scaled-up to larger sizes. Three options for the thrust bearing design of a particular pump-turbine were considered: (a) “semihard” supports for the pads such as a spring-disk insert, (b) “piston-type” supports in the back of the pads, which are machined to form shallow pistons that fit into recesses, allowing the pads to be supported hydrostatically, and (c) a symmetric arrangement of coil springs. In this instance, an upper limit of thrust bearing temperature was specified. Penalties would incur if this were exceeded. It is shown using a design code (GENMAT) that the best performance is achieved with a spring support (option c), arranged to give a convex film shape in the direction of sliding, and a slightly concave film in the radial direction. This is achieved by limiting the extent of the spring pack in the circumferential direction so that there are unsupported “overhangs” at the lead and trail edges. The radial concavity is arranged by having the spring pack extend edge-to-edge in the radial direction. The bearing has performed very well since commissioning. The original machining patterns are untouched after thousands of reversals under load. The pads appear as new.