Although various sports footwear demonstrated marked changes in running biomechanical variables, few studies have yielded definitive findings on the underlying mechanisms of shoe constructions affecting running-related performance and injuries. Therefore, this study focused on examining the effect of basic shoe constructions on running biomechanics and assessing the current state of sports shoe production in terms of injury and efficiency. Relevant literature was searched on five databases using Boolean logic operation and then screened by eligibility criteria. A total of 1260 related articles were retrieved in this review, and 41 articles that met the requirements were finally included, mainly covering the influence of midsole, longitudinal bending stiffness, heel-toe drop, shoe mass, heel flare, and heel stabilizer on running-related performance and injuries. The results of this review study were: (1) The functional positioning of running shoe design and the target groups tend to influence running performance and injury risk; (2) Thickness of 15–20 mm, hardness of Asker C50-C55 of the midsole, the design of the medial or lateral heel flares of 15°, the curved carbon plate, and the 3D printed heel cup may be beneficial to optimize performance and reduce running-related injuries; (3) The update of research and development concepts in sports biomechanics may further contribute to the development of running shoes; (4) Footwear design and optimization should also consider the influences of runners’ strike patterns.