Demotion to the Championship is not only a terrible thing for fans and players to experience, but it can lead to job losses and huge cuts to playing and non-playing staff.
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But three teams have to go, and with four points separating 16th to 19th, we are in for an incredible final two games of the season.
With Southampton already down, Nottingham Forest, Everton, Leeds and Leicester are locked in a desperate fight for their lives.
Here, talkSPORT.com looks at the 2022/23 relegation battle in detail…
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Nottingham Forest - 16th
Nottingham Forest have endured a strange season back in the Premier League that started with a crazy summer.
Steve Cooper's men saw a huge influx of players, leading to some disjointed performances, particularly away from home.
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The World Cup break helped settle everything down, and they have been impressive at the City Ground but have the league's worst away form.
After defeat to Leeds last month, things looked bleak for Forest, but crucial wins over Brighton and Southampton have massively boosted their survival hopes.
A draw with Chelsea has moved the Tricky Trees three points clear of the drop zone, so they are nearly safe but face Arsenal and Crystal Palace in their last two.
Forest have shown remarkable resilience in recent weeks and should have done enough to maintain their top-flight status.
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Predicted finish - 16th
Everton - 17th
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Everton looked doomed under Frank Lampard, but they acted quickly and decisively to replace the Chelsea legend with Sean Dyche.
Dyche worked wonders on a limited budget at Burnley and has won four games as Toffees boss, picking up a shock emphatic victory away at Brighton last time out.
They were then beaten by Manchester City, meaning it all comes down to the fixtures against Wolves and Bournemouth.
One win in those final two ties should be enough for Dyche to save the Toffees.
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Predicted finish - 17th
Leeds - 18th
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Leeds are embroiled in a relegation battle for the second consecutive campaign.
The west Yorkshire side survived on the final day of the season last year after a win over Brentford that relegated Burnley.
But Jesse Marsch wasn't able to build on that and was sacked earlier this year, and ex-Watford manager Javi Gracia was given the chance to save the club.
The Spaniard made a good start, but relegation specialist Sam Allardyce was called upon to replace Gracia after a terrible run of results.
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Leeds were beaten by Man City in his opening game in charge but then grabbed a 2-2 draw against Newcastle.
West Ham and Tottenham are their final fixtures of the season, and Allardyce will most likely need to win at least one of those to keep Leeds in the Premier League.
Predicted finish - 18th
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Leicester - 19th
From title winners to relegation candidates in seven years, it's been a strange journey for Leicester and it looks set to end badly.
Brendan Rodgers was replaced by Dean Smith, and despite having a squad packed with quality players, including James Maddison, poor defending has seen them lose 22 times this season.
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And with two games to go, the Foxes are now in desperate need for points with two tough fixtures remaining to survive.
A draw at home to Everton preceded heavy defeats to Fulham and Liverpool, which has left the Foxes staring the Championship in the face.
Leicester face Newcastle next before West Ham visit on the final day.
Smith's side are two points from safety, so would need to find results from somewhere to stay up, and as it stands, chances of that are slim.
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Predicted finish - 19th
Southampton - 20th
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Southampton have been bottom of the Premier League since New Year's Eve and are onto their third manager of the season in Ruben Selles.
Ralph Hasenhuttl and Nathan Jones failed to get much from this group of players, and Selles didn't either - as the Saints have been officially relegated.
Southampton are eight points from safety with only two games to go.
It has been a season to forget for the Saints, and they will be playing Championship football for the first time since 2012 next year.
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Predicted finish - 20th