Bonnano Pisano, the engineer in charge, sought to compensate for the lean by making the new stories slightly taller on the short side, but the extra masonry caused the structure to sink still further. Work was suspended several times as engineers sought solutions, but the tower was ultimately topped out in the 14th century, still leaning.

The foundations have been strengthened by the injection of cement grout and various types of bracing and reinforcement, but in the late 20th century the structure was still subsiding, at the rate of 0.05 inch (1.2 mm) per year, and was in danger of collapse. In 1990 the tower was closed and the bells silenced as engineers undertook a major straightening project. Earth was siphoned from underneath the foundations, decreasing the lean by 17 inches (44 cm) to 13.5 feet (4.1 metres); the work was completed in May 2001, and the structure was reopened to visitors. The tower continued to straighten without further excavation, until in May 2008 sensors showed that the motion had finally stopped, at a total improvement of 19 inches (48 cm). Engineers expected the tower to remain stable for at least 200 years.