With the awareness of environmental protection and resource conservation, the efficient use of industrial waste has drawn much attention. As an alternative to natural aggregates, steel slag aggregate (SSA) has been investigated widely and has shown good performance and benefits in concrete applications. This chapter details the characteristics of SSA and current utilizations of SSA in cement concrete in two sections. The current application, sustainability, production, classification, chemical composition, physical properties, volume stability, pretreatments and posttreatments of SSA are discussed in detail. The concrete section discusses the workability, strength, shrinkage, corrosion resistance, radiation shielding, conductivity and metal contamination of concrete incorporating SSA. The SSA content and the performance of SSA concrete vary due to the different properties of SSA. Generally, SSA is a potentially promising aggregate substitution with proper treatments and concrete mix design.