Alternative Project Delivery Methods (APDMs), namely Design Build (DB) and Construction Manager at Risk (CMAR), grew out of the need to find a more efficient project delivery approach than the traditional Design Bid Build (DBB) form of delivery. After decades of extensive APDM use, there have been many studies focused on the use of APDMs and project outcomes. Few of these studies have reached a level of statistical significance to make conclusive observations about APDMs. This research effort completes a comprehensive study for use in the horizontal transportation construction market, providing a better basis for decisions on project delivery method selection, improving understanding of best practices for APDM use, and reporting outcomes from the largest collection of APDM project data to date. The study is the result of an online survey of project owners and design teams from 17 states representing 83 projects nationally. Project data collected represents almost six billion US dollars. The study performs an analysis of the transportation APDM market and answers questions dealing with national APDM usage, motivators for APDM selection, the relation of APDM to pre-construction services, and the use of industry best practices. Top motivators for delivery method selection: the project schedule or the urgency of the project, the ability to predict and control cost, and finding the best method to allocate risk, as well as other factors were identified and analyzed. Analysis of project data was used to compare to commonly held assumptions about the project delivery methods, confirming some assumptions and refuting others. Project data showed that APDM projects had the lowest overall cost growth. DB projects had higher schedule growth. CMAR projects had low design schedule growth but high construction schedule growth. DBB showed very little schedule growth and the highest cost growth of the delivery methods studied. Best practices in project delivery were studied: team alignment, front end planning, and risk assessment were identified as practices most critical to project success. The study contributes and improves on existing research on APDM project selection and outcomes and fills many of the gaps in research identified by previous research efforts and industry leaders.