A Sustainability Opportunity Study (SOS) can be used to highlight and make sense ofsustainability in any chosen business and in any area of sustainability. In this paper we studysustainability opportunities for Swedish cement and concrete. Emissions from cement, thebinder in concrete, play an important role in climate effects for the entire building value chainputting pressure on change. These change challenges have further been accentuated by therecent crisis for the sole Swedish cement producer that has been denied continuing its quarryingoperations in its main factory that delivers 75% of the Swedish cement. Even if permissionissues could be solved the signal is there that circular solutions not relying on an end of the pipebusiness model are needed. The international cement industry might also have to rethink theentire business idea. We study both how to understand sustainability opportunities in cementand concrete manufacturing and the theoretical implications of it for the SOS. The paperproposes a further development of the SOS and the matrix that combines Understand-Define-Measure with Diagnosing-Analysing-Solving. We focus on creating a better understanding forthe parts of Diagnosing using cement and concrete as examples.Results indicate that there are alternatives to using virgin limestone as raw material in cementand that we should focus on concrete sustainability performance to reduce the carbon footprint.In Diagnosing Understanding the start should be in the business concept and its sustainabilityin comparison with the four system principles.