Concrete repair and rehabilitation are vital disciplines in structural and civil engineering, given the age of concrete infrastructure and the need to extend its service life. Most repair projects involve removing deteriorated or damaged concrete, followed by applying a patch repair mortar or bonded overlay. These repairs are typically done with proprietary repair materials of very high strength exceeding 40 MPa, which is related to the general misconception that the high strength of cementitious materials correlates with high quality and structural contribution. However, the performance of concrete repairs deteriorates with the increasing strength of the repair material, which is related to an increasing tendency to crack and debond. Furthermore, repair patches commonly do not contribute to the load-bearing behaviour of the structure, mainly because of creep and shrinkage of the repair mortar. This paper discusses common misconceptions around the ‘structural repair’ of concrete members and the related adverse effects regarding sustainability costs. Recommendations for rational and more sustainable repair approaches are presented.