The use of Alternative Technical Concepts (ATC) is becoming widespread in design-build transportation projects in the United States. According to Federal Highway Administration (FHWA) ATC is a request by a proposer (usually in design-build projects) to modify a contract requirement for gaining competitive advantage over competition. The owner, usually a state department of transportation, requires that the ATC provide a better or at least equal solution to the owner’s design requirements. In Design-Build (DB) projects, the ATC is usually proposed by a proposer during the Request for Proposal (RFP) process and is considered in the evaluation and selection of the proposers in conjunction with the Best Value (BV) method of selection. In this paper, the authors have focused on two case studies involving ATC implementation and negotiations with the Massachusetts Department of Transportation (MassDOT) highlighting advantages and disadvantages of using ATC in DB contracts. In each case, the nature of ATC and the approval process is discussed. In the first case, the approved ATCs provided the proposer with a clear advantage in winning a contract with the agency despite not being the low bidder. In the second case, the proposed and approved ATCs did not result in winning a contract despite being the low bidder.