Operations strategies focus on how a firm delivers value, while business strategies focus on what to deliver and where. Lean is an operations strategy prioritizing flow efficiency. In construction, empirical underpinning of operations strategies has been limited. The aim is to capture how perceptions of operations strategy in construction practice aligns with existing theories of operations strategy organized in decision categories. Nine in-depth interviews with contractor middle managers were transcribed and analyzed to capture their perceptions of operations strategies. Results show: (1) decision categories in construction differ from manufacturing, and (2) differences between resource and flow efficient operations strategies exist. A resource efficient strategy focuses cost and delivery as competitive criteria, while customer value is targeted in a flow efficient strategy. Proposed structural decision categories are standardization, organization and production planning, supply chain, and infrastructural decision categories are human resources, continuous improvement, long-term perspective, process vs. project, and performance measurements. Infrastructural categories are more difficult to replicate and render competitive advantage if successfully aligned with business strategy. An operations strategy strictly focused on project delivery, such as lean construction, is not automatically aligned with the business strategy, but can achieve satisfactory project performance.