High-performance recycled aggregate concrete (HP-RAC) offers a sustainable alternative to natural aggregate concrete (NAC), addressing environmental concerns related to resource depletion and construction waste. This critical review synthesizes recent experimental findings on the mechanical and durability performance of HP-RAC. Indicative trends show that with 25–50% recycled aggregate replacement, HP-RAC can achieve compressive strength levels reaching 88–100% of NAC. Further enhancements are observed when supplementary cementitious materials (SCMs) such as fly ash, silica fume, or slag are incorporated. Fiber reinforcement contributes to modest gains in tensile and flexural strength. Durability improvements—such as reduced chloride ion penetration, lower carbonation depth, and enhanced freeze–thaw resistance—are consistently reported when SCMs are combined with aggregate pre-treatment. However, performance variability remains due to differences in aggregate quality, mix design, and curing regimes. Microstructural analyses confirm that improved mixes exhibit densified interfacial transition zones and reduced porosity. While HP-RAC demonstrates strong potential for structural applications, further research is needed to standardize mix design procedures, quantify uncertainty, and assess long-term performance. This review provides a comprehensive foundation for promoting HP-RAC as a reliable and environmentally responsible construction material.