Mitotic spindle orientation has been linked to asymmetric cell divisions, tissue morphogenesis and homeostasis. The canonical pathway to orient the mitotic spindle is composed of the cortical recruitment factor NuMA and the molecular motor dynein, which exerts pulling forces on astral microtubules to orient the spindle. Recent work has defined a novel role for NuMA as a direct contributor to force generation. In addition, the exploration of geometrical and physical cues combined with the study of classical polarity pathways has led to deeper insights into the upstream regulation of spindle orientation. Here, we focus on how cell shape, junctions and mechanical tension act to orient spindle pulling forces in epithelia, and discuss different roles for spindle orientation in epithelia.