Energy foundations and other thermo-active ground structures, energy wells, and pavement heating represent an innovative technology that contributes to environmental protection and provides substantial long-term cost savings and minimised maintenance. The paper focuses on earth-contact concrete elements that are already required for structural reasons, but which simultaneously work as heat exchangers. Absorber pipes filled with a heat carrier fluid are installed within conventional structural elements (piles, barrettes, diaphragm walls, basement slabs or walls, tunnel linings), forming the primary circuit of a geothermal energy system. The natural ground temperature is used as a heat source in winter and for cooling in summer. Hence no additional elements have to be installed below surface. The primary circuit is then connected via a heat pump to a secondary circuit within the building. ‘Free cooling’ may even run without a heat pump. The paper describes heat transfer in the ground, and between absorber fluid and concrete/soil. Temperature-induced changes of soil properties or of foundation behaviour are also discussed, and recommendations for design and operation are given. Pilot research projects and case histories bridge the gap between theory and practice, and special applications reveal the wide field of geothermal geotechnics.