Long-span steel trusses are increasingly used in high-rise buildings to replace reinforced concrete thick transfer plate due to light weight and high load-bearing capacity. To support multi-stories above the steel transfer truss, a comprehensive method based on second-order direct analysis method has been applied for optimization design of long-span steel transfer truss in the Redevelopment of Hong Kong Kwong Wah Hospital (KWH) – Phase 1. In the project, a 35m long-span steel transfer truss is adopted at the 3rd to 5th floors to support the above 15-story reinforced concrete structure. Innovative technologies such as the integrated global and local optimization, the integrated design and construction have been explored and made to achieve better uniformity and harmony in structure. In particular, twin trusses with better structural performance, less fabrication cost and ease of constructability are studied and finally adopted in main trusses to replace original single trusses. The optimal scheme has brought both cost and time saving in fabrication, construction, operation and maintenance stages.