Tightly collimated relativistic outflows, known as jets, are ubiquitous across a wide range of astrophysical systems including active galactic nuclei. How jets emerge near the black hole and survive long-range propagation through their parent galaxies is not understood. In this talk, I will discuss the insights into these processes coming from first-principles models of black hole accretion. Namely, using general relativistic magnetohydrodynamic simulations, which describe the motion of magnetized gas on a curved space-time of a spinning black hole, I will report on the crucial roles that disk misalignment, dynamically-important magnetic fields, and the interaction with the ambient medium play in jet lives. I will finish by discussing the observational manifestations of these physical effects on the scales ranging from the event horizon to the entire galaxy.