High strength lightweight concrete (HSLC) has been studied extensively in the laboratory and used in projects over the last decade. Its lightweight and high strength characteristics are advantageous, but HSLC also presents several challenges. Few studies have focused on the issues associated with the field implementation of HSLC. These issues are explored and addressed in this study. There are small differences in the compressive strength, unit weight, modulus of elasticity, tensile strength, and bond strength of HSLC between the laboratory and the field. Special considerations during mixture design, careful moisture control of the lightweight aggregates (LWA), and consolidation are crucial for minimising variability and maintaining performance in the field.