Paved surfaces must reliably bear heavy loads, often under challenging environmental and geotechnical conditions. These requirements are addressed through the use of high-quality, newly produced materials in pavement design. However, in remote locations, newly produced materials are often expensive or unavailable, making waste or alternative materials more attractive. Waste materials can be used in their natural condition but are more commonly stabilised or otherwise improved to meet performance targets. However, this practice can incorporate unwarranted risk into pavement design solutions. The decision to use waste materials in a pavement is a balance between technical risk, maintenance liability, available materials, environmental emissions and capital cost. This study reviews the use of waste materials in pavement design and construction. Reclaimed asphalt pavement (RAP) materials and processed waste plastic for pavement construction are considered. Additionally, blast furnace slag (BFS) and waste glass in pavement construction are evaluated. This review focuses on the effects of alternative materials on the properties of asphalt pavement. The results indicate that RAP is acceptable as an alternative material, while BFS, waste plastic and waste glass can be used under specific conditions. Also, the current and future challenges for the use of waste materials in the pavement industry are discussed.