Numerous studies have focused on the distinction between categorical and coordinate spatial relations. Categorical relations are propositional and abstract, and often related to a left hemisphere advantage. Coordinate relations specify the metric information of the relative locations of objects, and can be linked to right hemisphere processing. Yet, not all studies have reported such a clear double dissociation; in particular the categorical left hemisphere advantage is not always reported. In the current study we investigated whether verbal and spatial strategies, verbal and spatial cognitive abilities, and gender could account for the discrepancies observed in hemispheric lateralization of spatial relations. Seventy-five participants performed two visual half field, match-to-sample tasks (Van der Ham et al., 2007; 2009) to study the lateralization of categorical and coordinate relation processing. For each participant we determined the strategy they used in each of the two tasks. Consistent with previous findings, we found an overall categorical left hemisphere advantage and coordinate right hemisphere advantage. The lateralization pattern was affected selectively by the degree to which participants used a spatial strategy and by none of the other variables (i.e., verbal strategy, cognitive abilities, and gender). Critically, the categorical left hemisphere advantage was observed only for participants that relied strongly on a spatial strategy. This result is another piece of evidence that categorical spatial relation processing relies on spatial and not verbal processes.