<p>In industrial scenarios with frequent dynamic loading—such as heavy-duty factory buildings, military defense structures, and containment structures of nuclear power plants—cement-based materials are required to possess high toughness to resist impact loads. However, traditional cement-based materials suffer from high brittleness and low toughness. Therefore, developing high-toughness cement-based materials has become a key topic in the field of civil engineering materials. Inspired by the “brick–mortar” structure and exceptional toughness of nacre, nacre-inspired cement-based composites have been fabricated using methods such as ice templating, layer-by-layer stacking, and 3D printing. The findings demonstrate that nacre-inspired cement-based composites have ductile fracture properties without compromising strength, in contrast to the brittle fracture behavior of traditional cement. This review comprehensively examines the research advancements of nacre-inspired cement-based composites, focusing on the three toughening mechanisms of natural nacre, along with the fabrication process, performance benefits, toughening strategies, future outlook, and application potential of these composites. It underscores the necessity for comprehensive exploration of material properties, interface design, fabrication techniques, and gradient structures in the design and preparation of nacre-inspired cement-based composites to enhance the evolution of cement-based materials that combine high strength and exceptional toughness.</p>