Identification of the factors influencing refractory lining wear and its residual thickness in the basic oxygen furnace (BOF) is a prerequisite for optimizing the steelmaking process. In this study, the factors that contribute significantly to the wear of the refractory lining in the most stressed areas of the banded lining (i.e., the trunnion ring area and slag line area) are identified. Knowledge of the rate at which a given factor acts on refractory wear is closely related to the development of technological procedures aimed at limiting its influence. This research evaluates the technological causes and describes the lining wear mechanism and the thermodynamic parameters of the reactions between the MgO–C metal, slag, and gunning material phases. In researching the topic, real operational data were processed using statistical methods and data analysis, which were supported by thermodynamic modeling of chemical reactions. The results show that the combination of technological factors, mechanical action of the raw materials, blowing and free oxygen in the metal, silicon from the pig iron, and slag viscosity have the greatest influence on the residual thickness of the MgO–C refractory lining in BOFs. Refractory gunning material consumption, its effect on campaign length, and the cost-effectiveness of repair work were also analyzed.