Elite European men’s basketball features a wide range of offensive play-types designed to create high-quality scoring opportunities. Understanding the use and effectiveness of these actions is essential for performance analysis and tactical planning. This study explored perceptual-motor patterns in elite basketball through a comparative analysis of offensive play-type usage and scoring efficiency across six major European leagues during the 2022–2023 season. A total of 5,044 possessions from top-ranked teams were analyzed using Synergy Sports data, classifying each action by play-type and measuring effectiveness through points per possession (PPP). Results showed that Spanish teams favored Pick & Roll Ball Handler (P&R BH) and Spot Up actions, French and German teams exhibited higher usage of Isolation and Transition plays, while Greek and Turkish teams leaned toward Cut and Post Up actions. Efficiency metrics revealed that although usage patterns varied, certain play-types such as Cuts and Transition consistently produced higher PPP across leagues. Differences in ε 2 values suggested medium-to-large effects in usage and efficiency variability between countries. These findings highlight how tactical preferences and contextual league structures shape the perceptual-motor strategies used in elite basketball. The findings reveal which offensive play-types are most efficient and frequently used across leagues, providing valuable insights for tailoring offensive schemes to specific contexts. Coaches can use these results to prioritize play-types that yield higher effectiveness in particular leagues, while scouts may identify players whose experience aligns with specific tactical environments.