This paper reviews actual sustainability assessments in the construction sector to define whether and how a Life Cycle Sustainability Assessment (LCSA) is applied and interpreted in this sector today. This industry has large shares in global energy (33%), raw material consumption (40%) and solid waste generation (40%). Simultaneously, it drives the economy and provides jobs. The LCSA is a method to identify environmental, social and economic impacts of products/services along their life cycles. The results of this study showed a mismatch between sectoral emissions and the number of LCSA-based impact evaluations. It was found that only 11% of papers reviewed assessed all three sustainability pillars. The economic and especially the social pillars were partly neglected. In Life Cycle Assessments (LCAs), 100% made use of Global Warming Potential (GWP) but only 30% assessed more than five indicators in total. In Life Cycle Costing (LCC), there were a variety of costs assessed. Depreciation and lifetime were mainly neglected. We found that 42% made use of Net Present Value (NPV), while over 50% assessed individual indicators. For the Social Life Cycle Assessment (S-LCA), the focus was on the production stage; even the system boundaries were defined as cradle-to-use and -grave. Future approaches are relevant but there is no need to innovate: a proposal for a LCSA approach is made.