The incorporation of nanotechnology has led to significant strides in the concrete industry, ushering in innovative construction methodologies. Various nanomaterials, including nano-silica (NS), have undergone comprehensive scrutiny as potential partial substitutes for cement in concrete formulations. This article aims to provide a comprehensive overview of the impacts of NS on several mechanical properties of concrete, encompassing compressive, split tensile, and flexural strengths. Additionally, the review delves into the influence of NS on the concrete’s durability, including microstructural characterization and the eradication of structural micropores. NS has demonstrated the capacity to bolster both strength and durability while concurrently diminishing structural micropores. Moreover, this review explores the contemporary status of NS application in cement concrete and presents avenues for prospective research. The assessment of engineering attributes becomes imperative for concrete infused with nano-silica. This encompasses aspects like bond strength, creep, shrinkage, and more. A rigorous evaluation of fresh and hardened properties is necessary to discern the material’s thermal and acoustical characteristics. Such a comprehensive understanding contributes to a holistic evaluation of the material’s adaptability across diverse applications.