This study assessed advancements in self-healing cementitious systems, which comprised natural autogenous mechanisms and engineered interventions. Autogenous healing relies on ongoing hydration, calcium carbonate precipitation and the swelling of hydration products to restore microcracks. Engineered systems employ biological agents, polymers, fibres, shape memory materials and expansive additives to enhance repair capacity. Bacteria-based strategies, particularly those using Bacillus pasteurii, achieve recovery of mechanical properties through mineral precipitation, with encapsulation methods such as alginate beads and clay microcapsules extending microbial viability. Fungal agents, such as Fusarium oxysporum and Trichoderma reesei, form mycelial networks that promote calcium carbonate deposition across broader crack regions under varying pH and oxygen conditions. Polymeric agents, such as epoxy, polyurethane and PMMA, rely on controlled chemical reactions activated by crack formation, while fibres and expansive additives restrict crack propagation and facilitate mineral-based sealing. Ultra-high-performance fiber-reinforced concrete demonstrates enhanced self-healing through controlled environmental exposure, frost-melt saturation and microcrack management. The study assessed the efficiency of these mechanisms in restoring structural integrity, reducing permeability and limiting reinforcement corrosion. Current limitations comprise of environmental sensitivity, temperature dependence, nutrient delivery challenges and reduced performance in marine or chemically aggressive conditions. The study recommended the development of multi-agent systems capable of sustained activity under diverse conditions, integration of encapsulation technologies and improved compatibility with field-scale applications. These strategies aim to extend service life, reduce maintenance requirements and support the long-term durability of reinforced concrete structures.