<p>Voided slab system has been widely used in Europe and are rapidly gaining acceptance in the United States, Middle East, and other regions due to their ability to reduce self-weight, enable longer spans, and improve overall structural efficiency. Despite their increasing use, ACI 318-25 does not provide design provisions for voided slabs, leaving engineers without unified guidance for analysis, design, and construction. This paper addresses this gap by synthesizing current design practices and validating them through an experimental database. The structural behavior of voided slabs is reviewed, and the applicability of conventional flexural analyses is evaluated and confirmed through experimental comparison. For serviceability, a practical stiffness modifier of 0.9 can be adopted in design software. Several one-shear reduction models are examined, and the most accurate approach is identified based on comprehensive comparison with test results of 49 specimens. Additional topics including punching shear, local punching, fire resistance, and construction detailing are assessed to provide a complete understanding of system performance. Beyond summarizing design procedure, the paper offers engineering recommendations supported by experimental evidence, clarifying when current ACI provisions are sufficient and when additional considerations are needed. The study also emphasizes critical construction practices for voided slabs system. Overall, the paper provides a consolidated and practice-oriented framework for the design and construction of voided slab systems, offering validated guidance to engineers and addressing the current absence of specific provisions in ACI 318-25.</p>