In the operations management and sustainability literature, the integration of Lean and Green manufacturing is considered one of the great solutions to balancing operational gains and environmental sustainability. This literature focuses mainly on the integration between them. However, there are no studies investigating how this integration is related to the Operations Strategy content: competitive priorities and decision areas. Thus, this study aims to contribute to reducing this research gap by providing a more in-depth understanding of the relationships between Lean-Green practices from the point of view of the Operations Strategy. We identify synergies and potential trade-offs between competitive priorities and changes in decision areas when Lean-Green practices are implemented. We performed a systematic literature review to answer two questions: Does the implementation of Lean and Green practices affect operations’ competitive priorities, causing synergies or trade-offs? What decision area(s) are modified with the implementation of each practice? This systematic review analyzed 338 selected articles. Competitive priorities, decision areas, Lean practices, Green practices and Lean-Green practices were identified and discussed, highlighting trade-offs, synergies and changes in decision areas. The results suggest that Lean and Green are synergistic in most practices, but they must be managed according to the Operations Strategy, especially as their focuses are essentially different and trade-offs may occur.