There have been many exciting and innovative developments in the construction sector over the last 50 years. Some extraordinary and iconic structures have been built around the world and designers’ computational capabilities have been revolutionized. There have also been developments in the use of new materials, sensors and analysis tools. However, what has truly transformed the way we design, build and operate our infrastructure and, in particular, concrete structures over this period? The “game-changers” are less clearly identifiable. What would industry experts list as the three most significant developments in the construction industry over this period and what have been the resulting effects on safety, cost, productivity and performance? What is the construction industry’s equivalent to sending someone to the moon, or finding the cure for cancer? Is there consensus on what the “holy grails” for the construction industry might be, and can we provide the evidence to garner support from government and industry to fund a focused quest for solutions? This paper aims to stimulate a dialogue that may encourage current and emerging researchers to harness new and evolving technologies to deliver solutions that will truly transform the construction industry and contribute to an improved quality of life for all.