Nearly zero energy buildings (nZEB) are considered a key measure to reduce energy consumption in buildings. However, there is growing evidence that nZEB design strategies may impact indoor environmental quality (IEQ). Most of the current research on nZEB has focused on the energy efficiency and cost-effectiveness of nZEB, with less research on the IEQ of nZEB. This literature reviewed 25 case studies on IEQ assessment to determine the actual IEQ performance in nZEB and the impact of design strategies on IEQ. The results showed that all four parameters of IEQ performance assessment have yet to be included in the scope of IEQ assessment. In addition to physical parameter measurements and criteria, subjective measurements should be the primary determinant of IEQ. Moreover, the analysis shows that overheating, poor air quality, thermal discomfort, and Sick Building Syndrome (SBS) are common IEQ risk factors reported. At the same time, the building envelope, HVAC system, and control system are the main factors contributing to the increase in IEQ risk factors. This review will provide practical reference values and recommendations for building professionals in future studies.