It is well known that heterogeneities in carbonate reservoirs impact fluid flow during production. However, few studies have examined the impact of the same heterogeneities on flow behaviour with different fluid properties and production scenarios. We use integrated flow simulation and experimental design techniques to investigate the relative, first-order impact of stratigraphic and sedimentological heterogeneities on simulated recovery in carbonate ramp reservoirs. Two production strategies are compared, which promote dominance of either horizontal or vertical flow. We find that the modelled geology is more important than the simulated fluid properties and production scenarios over the ranges tested. Of the heterogeneities modelled here, rock properties and stratigraphic heterogeneities that control reservoir architecture and the spatial distribution of environment of deposition (EOD) belts are important controls on recovery regardless of the production strategy. The presence of cemented hardground surfaces becomes the key control on oil recovery in displacements dominated by vertical flow. Permeability anisotropy is of low importance for all production strategies. The impacts of stratigraphic heterogeneities on recovery factor and water break-through are more strongly influenced by fluid properties and well spacing in displacements dominated by vertical flow. These results help to streamline the reservoir modelling process, by identifying key heterogeneities, and to optimize production strategies.