Due to their benefits in interior thermal comfort, energy saving, and noise reduction, radiant cooling systems have received wide attention. Radiant cooling systems can be viewed as a part of buildings’ maintenance structure and a component of cooling systems, depending on their construction. This article reviews studies on heat exchange in rooms utilizing radiant cooling systems, including research on conduction in radiant system structures, system cooling loads, cooling capacity, heat transfer coefficients of cooling surfaces, buildings’ thermal performance, and radiant system control strategy, with the goal of maximizing the benefits of energy conservation. Few studies have examined how radiant cooling systems interact with the indoor environment; instead, earlier research has focused on the thermal performance of radiant cooling systems themselves. Although several investigations have noted variations between the operating dynamics of radiant systems and conventional air conditioning systems, the cause has not yet been identified and quantified. According to heat transfer theory, the authors suggest that additional research on the performance of radiant systems should consider the thermal properties of inactive surfaces and that buildings’ thermal inertia should be used to coordinate radiant system operation.