In March 1998 the thaumasite form of sulfate attack (TSA) was identified in the reinforced concrete foundations of Tredington Ashchurch Road Bridge on the M5 Motorway in Gloucestershire, UK and the UK Government’s Highways Agency appointed Halcrow to investigate the problem. A total of 28 structures were selected for investigation to encompass sites where bridge works were planned and structures were assessed to be at greatest risk as well as to provide a representative sample of sites and structure types. Desk study work and peer reviews were continued throughout the project to establish protocols for the site work and facilitate the interpretation of the data. The latter included a dual approach of a systematic examination of the data collected to identify trends coupled with a review of postulated mechanisms for the formation of thaumasite from the desk study work against the data from the investigation. This paper summarises the findings of this review, which examines in detail four proposed stages in the development of TSA.