All companies have an operations strategy; a pattern of decisions made in operations with the purpose to support the business strategy. Lean Construction can be seen as an operations strategy. The aim of this research is to present the generic decision categories in an operations strategy and discuss their characteristics in contrast to the Lean Construction framework. A literature study identified ten decision categories: process technology, capacity, facilities, vertical integration, human resources, organization, quality, production control, product development, and performance measurement. Data was collected through in-depth interviews with managers on the tactical level at three construction companies with a Lean implementation. The results indicate that Lean construction companies emphasize quality, production planning, and vertical integration in their operations strategy. Facilities, process technology, capacity, and organization receive less attention. Quality, production planning, and vertical integration are keywords also in Lean Construction, while it is intriguing that organization receives little attention. Facilities, process technology, and capacity are ever changing between construction projects and are candidates for decision categories that could be less relevant for formulating an operations strategy in construction.