Cementitious composites often crack because of their low tensile strength. The ability of self-healing cementitious composite to automatically repair cracks has attracted widespread attention. Lightweight aggregate (LWA) has a low density and a high porosity which can provide storage space for a healing agent. The healing mechanisms and healing compositions of lightweight self-healing concrete (LWSHC) have been summarized in this research. The workability, compressive strength, crack repairing, and durability of LWSHC performance is also illustrated. A LWA with interconnected pores and a high strength should be integrated into LWSHC to increase the crack closure rate and mechanical properties. Expanded perlite is the most suitable LWA carrier for bioremediation. The chemical healing agents are better than the biological healing agents at present since the biological healing agents have more negative effects. A sodium silicate solution is a good choice as a chemical healing agent. Vacuum conditions, high-temperature processing, and the use of coating technologies on LWAs can improve the healing effect of LWSHC. The addition of fibers also enhance the self-healing ability of LWSHC. Further, the use of numerical simulation supports the healing performance of LWSHC. The goal of this research is to investigate the most appropriate component of LWSHC to ensure a high crack closure rate, strength healing ratio, and great durability while being lightweight. It can then be adopted in high-rise and large-span concrete structures to extend the service life.