We use a novel dataset extracted from the Society of Information Management’s (SIM) survey of chief information officers (CIOs) and top information technology (IT) executives to examine organizations’ most critical IT management issues during 2014-2017 and their effect on firm profitability. According to the SIM surveys, the top two IT issues management prioritizes are security/cybersecurity/privacy and IT alignment with the business. We find that firms that prioritize these two IT management issues exhibit higher profitability than firms that do not. Our study contributes to the Information Systems (IS) and Accounting Information Systems (AIS) literature on IT business value by providing empirical evidence on IT-business alignment – and to some extent, IT security – positively affecting firm financial performance.