The tremendous urbanization pace of India calls for higher efficiency in housing development, currently typified by low productivity and poor sustainability performance. Although off-site construction (OSC) is a method of widely acknowledged efficiency, its current uptake in India is very low, and the factors hindering its wider adaptation have not been comprehensively researched. This paper employs interviews with experts, a questionnaire survey and the interpretive structural modelling (ISM) technique to achieve the following objectives: first, to reveal which factors are perceived as top barriers for OSC implementation in India; second, to develop a hierarchical model presenting the causality between these factors; and third, to propose the initiatives required for barriers with high impact on other barriers to be most efficiently tackled. The survey findings show that the barriers perceived as most important from the professionals’ point of view are design inflexibility, difficulties in storage and transportation, supply chain weaknesses, initial capital requirements and lack of skills. The ISM reveals, though, that the underlying causes for these barriers lie with factors such as public procurement regulations and the fragmentation of the sector. Therefore, the latter are the barriers that need to be targeted in priority, as per the suggested strategies.