This paper presents an analysis of research results for silica aerogel cement composites over the past twenty years. Recently, two trends in the development of these composites have been noted, towards structural applications and towards ultralight composites for coatings and renders. Ongoing research shows that important aspects of cementitious composites with good mechanical performance are the proper selection of aggregates and improved adhesion at the silica aerogel–cement binder interface, which will guarantee high compressive strength with the lowest possible thermal conductivity. The best physicomechanical performance of aerogel cement composites with low thermal conductivity below 0.03 W/(m·K) was obtained when cenospheres and aerogel were used in a weight percentage of 5%. In turn, the prerequisites for using aerogel cement composites as coatings for energy-efficient building façades are the use of large amounts of silica aerogel as a substitute for lightweight aggregates or the selection of an optimal composition of lightweight aggregates and aerogel, ensuring the lowest possible thermal conductivity coefficient. Other important standpoints are water transport and moisture protection of the silica aerogel-based coatings. Therefore, in recent years, more and more elements of the hygrothermal performance, porosity and durability of silica aerogel cement composites have been developed. The article also points out the weaknesses of the application of silica aerogel in the cement matrix, the most important of which are the lack of adhesion at the boundary of the aerogel–cement binder, the increased porosity of the composite, the high water absorption capacity and the significant decrease in compressive strength with large volumes of silica aerogel. Solving these issues will certainly contribute to the wider applicability of these materials in the construction industry.