This paper presents a new Damage Accumulation machine health indicator that trades precision for ease of use and broad applicability, effectively addressing the challenges of practically applying continuous monitoring to large numbers of assets such as pumps, motors, gearboxes, and fans. Damage Accumulation offers comprehensive early warning indication for a broad range of faults that can in turn be used to trigger detailed analysis. Damage Accumulation is a time series vibration analysis technique that estimates the rate at which damage is accumulated at a given location. This indicator accounts for time-varying symptoms in machines which are often overlooked by traditional vibration diagnostic frequency analysis or time series analysis. It also considers the contribution of repeated load reversal cycles to component damage and the nonlinearity in the relationship between damage and vibration amplitude. This paper presents the fatigue analysis foundation of Damage Accumulation and demonstrates its efficacy in a bench test and in a high pressure pumping field example.