Interfacial transition zone (ITZ) is the region of cement paste adjacent to the aggregate surface. Large size aggregates disturb the packing of cement in their near vicinity due to wall effect and form ITZ. The microstructure of ITZ is more porous and has higher calcium hydroxide (CH) content compared to the bulk cement paste. ITZ has been considered the weakest link in concrete due to its microstructure. The presence of ITZ is the reason of lower strength of concrete compared to its constituents, cement paste, and aggregate. Effect of ITZ on the transport properties of concrete is still a subject of debate. Improving the microstructure of ITZ is a good way of improving mechanical and transport properties of concrete. This paper reviews various alternative methods used for improving the microstructure of ITZ. © 2019, Springer Nature Singapore Pte Ltd.