Microwave heating is a highly efficient technique for various thermal processes. Advantages of microwave heating compared to conventional processing methods include energy-saving rapid heating rates and short processing times, deep penetration of the microwave energy (which allows heat to be generated efficiently without directly contacting the work-piece), instantaneous and precise electronic control, clean heating processes, and no generation of secondary waste. Microwave energy processes for heating, drying, and curing have been developed for numerous laboratory-scale investigations and, in some cases, have been commercialized. Microwave energy use should theoretically be advantageous in the processing of cement and concrete materials (e.g., hydraulic Portland cement, aggregate, and water). These materials exhibit excellent dielectric properties and, therefore, should be able to absorb microwave energy very efficiently and instantaneously convert it into heat. This paper provides a comprehensive review of the use of microwave energy to process cement and concrete materials, as well as a critical evaluation of currently utilized microwave heating mechanisms and high-performance microwave systems. The current status of microwave applications and future research and development trends are also discussed, including such thermal processing methods as the high-temperature sintering of cement materials, the accelerated curing of precast concrete products, as well as the drilling and cleaning of decontaminated concrete surfaces by the built-up internal pressure. The results of this review indicate that microwave heating is directly associated with dielectric loss by the cement and concrete. Microwave processing can be used to improve clinkering and to reduce the clinkering temperature by about 100 °C. Considerations when constructing mathematical models of microwave heating for cement and concrete should include the influences of heat and mass transfer during microwave curing on the temperature difference in the concrete, the degree of uniformity of the internal structure, and the ultimate performance of the product. Future studies of microwave energy in cement and concrete applications might include investigations of adaptive (time-dependent) dielectric properties, coupling chemical reactions in the presence of microwave energy, the design and construction of suitable microwave systems, and the prediction of related phenomena (e.g., thermal runaway, as a highly regulated safety issue).