State Transportation Agencies (STAs) recognized that to enhance the quality of construction documents, a review process must be incorporated into project planning, design, and procurement to evaluate projects for constructability. The benefits promised by constructability reviews (CRs) encouraged STAs to adopt it as part of their operations. This approach soon evolved into a structured process, recognized by researchers and practitioners as, the constructability review process (CRP). A significant component to the CRP success is to involve experienced construction personnel in CRs during the design phase; a major limitation of the traditional design-bid-build (DBB) delivery method. To overcome this limitation, more emphasis is being placed towards alternative project delivery methods (APDMs). As such, design–build (DB) and construction manager/general contractor (CM/GC) are among the APDMs most utilized by STAs to deliver transportation projects. Although extensive research has investigated CRs under DBB projects, research on CRs implementation under APDMs is remarkably absent. This study examines CRs utilization and staffing practices adopted by STAs across DBB, DB, and CM/GC projects. The results of this study were drawn utilizing data collected through a national survey questionnaire and interviews with selected STAs. The study found that CRs are initiated and implemented at proportionally similar phases across DBB, DB, and CM/GC projects. Investigation of staffing needs revealed that although the agency holds the executive role in implementation of CRs on DBB projects, their role shifts on DB projects to become more administrative. The agency continues to be involved in CRs under CM/GC projects, along with their allocated design consultant, in conjunction with the GC. The results of this study are anticipated to provide STAs with guidance for CRs utilization on DBB, DB and CM/GC projects.