Increasing the thermal resistance of masonry wall systems is one of the effective ways to reduce energy consumption in the operation of masonry buildings. This increase is also demanded by newer, more stringent energy codes. However, the effective thermal resistance ( R-value) of masonry walls is affected by many factors, such as thermal bridging, which occurs in places where highly conductive structural components penetrate insulating materials. Thermal bridging is common when connecting masonry veneers to structural backup walls. Furthermore, quick and precise methods for estimating the R-value are needed for thermal design improvements and code-compliance calculations. This study presents a comprehensive literature review on key factors that influence the overall thermal performance of masonry walls, methods to effectively estimate and measure R-values, and improvements in thermal design. In addition to identifying the main technical and practical challenges and the corresponding progress made on each front, key design considerations, such as code compliance, material properties, insulation types, and location, as well as special ties and shelf angles types, are also discussed. This study summarizes critical information and recommendations that will help improve the thermal design of masonry walls, hence reducing the energy consumption of buildings.