This review examines the impact of recycled aggregates (RAs) on the fresh and mechanical properties of high-strength concrete (HSC). The results revealed that incorporating RAs can reduce the compressive strength of HSC by up to 25%, with strength values ranging from 40 to 70 MPa depending on the RA content. The addition of supplementary materials like silica fume, fly ash, and polycarboxylate ether significantly mitigated these negative effects, enhancing the compressive strength by approximately 15–20% compared with the control mixes without additives. Furthermore, the tensile strength was observed to decrease by up to 18% with increasing RA content, but fiber reinforcement improved this by 10%, demonstrating the potential of additives to offset mechanical weaknesses. The modulus of elasticity also declined by up to 30% with higher RA dosages, highlighting the critical impact of the adhered mortar quality on the overall stiffness of the concrete. According to the literature, it was noticed that, when the dosage of RCAs is increased, there is a drop in the strength activity index (SAI). When the substitute dosage exceeded 50%, the SAI decreased. These findings underscore the importance of using optimized additive combinations to improve the mechanical performance of RA concrete, making it a viable option for sustainable construction. Overall, the findings suggest that, although RAs may negatively affect certain physical traits of HSC, the use of appropriate additives can optimize its performance, making it a viable option for sustainable construction practices.