The use of cement and concrete, among the most widely used man-made materials, is under scrutiny. Owing to their large-scale use, production of cement and concrete results in substantial emission of greenhouse gases and places strain on the availability of natural resources, such as water. Projected urbanization over the next 50–100 years therefore indicates that the demand for cement and concrete will continue to increase, necessitating strategies to limit their environmental impact. In this Review, we shed light on the available solutions that can be implemented within the next decade and beyond to reduce greenhouse gas emissions from cement and concrete production. As the construction sector has proven to be very slow-moving and risk-averse, we focus on minor improvements that can be achieved across the value chain, such as the use of supplementary cementitious materials and optimizing the clinker content of cement. Critically, the combined effect of these marginal gains can have an important impact on reducing greenhouse gas emissions by up to 50% if all stakeholders are engaged. In doing so, we reveal credible pathways for sustainable concrete use that balance societal needs, environmental requirements and technical feasibility.