Modular precast construction is a methodological approach to reduce environmental impacts and increase productivity when building with concrete. Constructions are segmented into similar precast concrete elements, prefabricated with integrated quality control, and assembled just-in-sequence on site. Due to the automatised prefabrication, inaccuracies are minimised and the use of high-performance materials is enabled. As a result, the construction process is accelerated, and the modules can be designed to be lightweight and resource-efficient. This contribution presents the fundamentals of modular constructions made from precast concrete components. Then, to elaborate the requirements of a contemporary modular precast construction, the historic developments are described. Further, concepts and technical processes–comprehensible to non-expert readers–are introduced to formalise the discussion about the current state-of-the-art methods. Three case studies treating ongoing research are introduced and related to the conceptual fundamentals. The research is evaluated with regard to current barriers and future directions. In conclusion, modular precast construction is able to reduce emissions and increase productivity in the sector if researchers and firms coordinate the development of suitable technologies that bring value to critical stakeholders.