The formation of stars above about 20M_{sun}_ and their apparently high multiplicity remain heavily debated subjects in astrophysics. We have performed a vast high-resolution radial velocity spectroscopic survey of about 250 O- and 540 B-type stars in the southern Milky Way which indicates that the majority of stars (>82%) with masses above 16M_{sun}_ form close binary systems while this fraction rapidly drops to 20% for stars of 3M_{sun}_. The binary fractions of O-type stars among different environment classes are: clusters (72+/-13%), associations (73+/-8%), field (43+/-13%) and runaways (69+/-11%). The high frequency of close pairs with components of similar mass argues in favour of a multiplicity originating from the formation process rather than from a tidal capture in a dense cluster. The high binary frequency of runaway O stars that we found in our survey (69% compared to 19-26% in previous surveys) points to the importance of ejection from young star clusters and thus supports the competitive accretion scenario.