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Such an evaluation is essential in this industry, which has been introducing a wide range of alternatives to cement binders yet achieved limited utilisation. It has been recognised that technical, environmental, and economic performance should be investigated for the broader adoption of alternative construction materials. Based on this approach, a state-of-the-art review was conducted to identify the key factors to consider when developing AABs. It was identified that AABs’ adverse performance compared to conventional cement-based materials mainly depends on the choice of which precursors and alkali activators to employ and the regionalised practices adopted (i.e., transportation, energy sources, and data on raw materials). In light of the available literature, increasing attention to incorporating alternative alkali activators and precursors by utilising agricultural and industrial by-products and/or waste seems to be a viable option for optimising the balance between AABs’ technical, environmental, and economic performance. 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