Concrete is the most used material on Earth except for water. Thus, there is much to be gained through improvements in the manufacturing of cement and the production of concrete to meet societal demand in a sustainable manner. This article reviews recent developments in three areas that have the potential to transform the ways in which infrastructure is specified, designed, and constructed: (1) expanding the use of supplementary cementitious materials and the identification of alternative supplementary cementitious materials, (2) growing the use of alternative cements and binder technologies, and (3) developing alternative reinforcement options. Strategies to facilitate the transfer of these emerging and next-generation materials and technologies from the research arena into real structures are also discussed.