The use of structural steelwork (SS) for buildings continues to grow worldwide owing to its sustainability benefits. However, the market share of SS in the building sector of Hong Kong greatly lags behind other markets. This paper focuses on providing a comprehensive understanding of the issues that greatly drive or inhibit SS adoption in Hong Kong from a project lifecycle perspective. The methodology encompasses both qualitative and quantitative approaches. Semi-structured interviews were conducted with 28 professionals from developer, structural engineering consultant, main contractor, steel specialist contractor, and steel stockholder companies. The results identified 12 driving factors and 25 barriers affecting SS adoption in Hong Kong. A questionnaire survey with 118 practitioners was carried out to identify the most important driving factors and barriers. The results revealed that “increased speed of construction” and “must-have requirements” were the two most important driving factors; while “shortage of skilled labor”, “shortage of supervisors working directly under main contractors”, “high construction costs”, “shortage of experienced designers and draughtsmen”, and “lack of education, training, and design experience on structural steelwork” were the five most critical barriers. This may imply that education and training are needed to improve knowledge and skills of professionals and workers, and thus to ensure an adequate supply of manpower. The findings of this study not only contribute to the existing body of knowledge on SS practices but also provide valuable references for helping practitioners and policymakers to promote sustainable construction methods within the building sector.