There seems to be scarcity in the current literature of empirical studies that explores project management innovation capabilities in developing countries in terms of factors potentially affecting its exploitation. This research aims at investigating, assessing, and discussing potential drivers, barriers, enablers and impacts for project management innovation processes in the context of Palestinian construction projects using a mixed methods approach. Based on systematic literature review and semi-structured interviews with construction projects experts, a specially designed project management innovation assessment survey has been conducted with managers within construction projects’ firms operating in the West Bank region of Palestine. A total of 1,000 surveys were electronically distributed, out of which 360 surveys returned usable data. The results of the analysis show that managers in the construction sector often perceive cost reduction as the most critical driver for project management innovation, and that the rewarding system is the main enabler for innovation, while the main barrier to innovation is the lack of effective management and the main impact of innovation is creating a competitive advantage. The value of this paper is the identification of project management innovation’s affecting factors in developing countries, and how innovation dynamics intersects with organisational well-being in such environments.