Concrete is the second-most used substance on Earth after water, and the production of cement accounts for at least 5% of the planet’s carbon emissions. Concrete has all sorts of excellent properties, which should not be overlooked, but it seems clear that we should be exploiting these fine properties against a backdrop of needing to look carefully at how we manage our concrete infrastructure sustainably. We need to use realistic approaches to understand structural integrity of our existing concrete infrastructure if we are not to needlessly condemn adequate structures. We need to understand how to prolong the life of existing concrete structures in a robust, proven and cost-effective manner, again so that additional carbon- and energy-related costs associated with rebuild are avoided. And we need to design our future concrete structures with the most important property of concrete at the forefront, namely its moudability, something which is seldom exploited, such that efficient use of concrete is ensured. This paper outlines research conducted in the BRE Centre for Innovative Construction Materials at the University of Bath in these areas of structural strengthening and future innovative design of concrete structures. The paper focuses on the role that structural fabric can play in contributing to these aims.