Asphalt binder is the most common material used in road construction. However, the need for more durable and safer pavements requires a better understanding of asphalt’s aging mechanisms and how its characteristics can be improved. The current challenge for the road industry is to use renewable materials (i.e., biomaterials not subjected to depletion) as a partial replacement for petroleum-based asphalt, which leads to reducing the carbon footprint. The most promising is to utilize biomaterials following the principles of sustainability in the modification of the asphalt binder. However, to understand whether the application of renewable materials represents a reliable and viable solution or just a research idea, this review covers various techniques for extracting bio-oil and preparing bio-modified asphalt binders, technical aspects including physical properties of different bio-oils, the impact of bio-oil addition on asphalt binder performance, and the compatibility of bio-oils with conventional binders. Key findings indicate that bio-oil can enhance modified asphalt binders’ low-temperature performance and aging resistance. However, the effect on high-temperature performance varies based on the bio-oil source and preparation method. The paper concludes that while bio-oils show promise as renewable modifiers for asphalt binders, further research is needed to optimize their use and fully understand their long-term performance implications.