Purpose This study aims to explore the level of adoption of Construction 4.0 (C4.0) technologies and of Lean Construction (LC) ambidexterity capability in China’s construction industry. By incorporating C4.0 and LC ambidexterity into a sociotechnical systems (STS) framework, this research provides practical insights for construction practitioners and companies seeking C4.0 and LC. Design/methodology/approach The study adopts the questionnaire survey method. Data was obtained from Chinese construction professionals working on projects using C4.0 technologies. The data were analysed using mean score ranking and three nonparametric techniques, including the Wilcoxon signed-rank test and the Spearman rank correlation. Findings According to the ranking analysis, building information modelling and offsite construction have the highest adoption level, while additive manufacturing and blockchain rank lowest. Digital technology is more widely used in China’s construction industry than in physical technology. Many C4.0 technologies are significantly correlated with LC ambidexterity. Based on the STS perspective, we propose a holistic approach that incorporates C4.0 technologies and LC ambidexterity. Originality/value Conceptually, the study incorporates C4.0 and LC ambidexterity into the STS framework. Empirically, this study fills the gap in the current literature by exploring the level of C4.0 technology adoption in the Chinese construction industry, as well as the level of LC ambidexterity capabilities. Construction companies can use this framework to make strategic decisions regarding investments in LC practices and the adoption of C4.0 technologies, such as investing in staff skill training and new technology deployment to adapt to the ever-changing environment.