Container terminals near airports often face significant height restrictions, making low-profile ship-to-shore container cranes vital. The latest generation of these cranes, built to service ultra-large container vessels, is significantly heavier and more complex than conventional A-frame cranes. In this paper, Kenton Lee, Michael Jordan, and Patrick McCarthy discuss key design issues and solutions from projects in Sydney, Fort Lauderdale, and Boston, including crane and component weights, wheel loads, geometry constraints, skidding, and fabrication challenges.