Road infrastructure projects are essential for a country’s economic and social development. Due to the magnitude, the projects are associated with considerable economic investments that in the case of failure can seriously affect regions’ economies. Despite the importance, roads from different countries are affected by cost overruns, hence, it is essential to identify and analyze the causative factors to focus the search for mitigation solutions. There are several studies focused on the cost factors identification, however, studies are lacking that synthesize and analyze the frequency and importance with which the factors have been reported to obtain a phenomenon overview. Therefore, this paper focuses on analyzing the frequency and importance with which cost overrun factors are reported in road projects. The research method consisted of a systematic review compound of five principal stages: (1) question formulation; (2) searching of relevant documents; (3) document selection; (4) evidence collection, analysis and synthesis; and (5) results’ report. Thirty-eight cost overrun factors were identified and classified into 14 categories. According to the Influence Index, the five most important and frequent cost overrun factors were: (1) failures in design, (2) price variation of materials, (3) inadequate project planning, (4) project scope changes, and (5) design changes.