The purpose in this paper is to do a Sustainability Opportunity Study (SOS) for Swedish cement and concrete production, while simultaneously improving the theoretical concept. There seems to be no agreed way of measuring organizational sustainability and sustainable development in common value chains, such as the building value chain. Without agreed definitions, agreed performance indicators are probably missing. Sustainability indicators can be proposed by doing an SOS, which identifies the main sustainability impacts in the studied value chain with focus on stakeholder needs. With proposed sustainability indicators, the improvement potential can be assessed. The SOS also identifies causes for the existing potential and proposes solutions. The starting point is the SOS matrix that combines the logic of Understanding-Defining-Measuring with the Opportunity Study steps of Diagnosing-Analysing-Solving. Results demonstrate that the SOS can be adapted to Swedish cement and concrete production resulting in proposed sustainability KPIs, identified main causes and proposed ways forwards.