This study provides a comprehensive review of the engineering challenges of formwork in concrete construction. The paper investigates different formwork systems, their design based on form pressure, and the difficulties of form stripping. Alternative binders are gaining more and more interest by opening new opportunities for sustainable concrete materials and their impact on form pressure and concrete setting is also investigated in this paper. The discussion involves several engineering challenges such as sustainability, safety, and economy, while it also explores previous case studies, and discusses future trends in formwork design. The findings pinpoint that choosing an appropriate formwork system depends significantly on project-specific constraints and that the development of innovative materials and technologies presents significant benefits but also new challenges, including the need for training and regulation. Current trends in formwork design and use show promising possibilities for the integration of digital technologies and the development of sustainable and ‘smart’ formwork systems. Continued research within the field has the possibility to explore new formwork materials and technologies, which will contribute to the implementation of more effective and sustainable practices in concrete construction.