<p>This review systematically explores and consolidates state-of-the-art developments in nano-transition metal oxide (NTMO)-modified geopolymer concrete (GPC), emphasizing their multifunctional performance emerging beyond conventional strength and durability enhancement. The inclusion of transition metal nano-oxides such as TiO₂, ZnO, Fe₂O₃, ZrO₂, CuO, NiO, and MnO into the environmentally superior GPC synthesized from fly ash, GGBS, and metakaolin results into introduction of multimechanistic synergies—acting concurrently as nano-fillers, nucleation promoters, and functional activator. Through integrated assessment, this review shows how coordinated nano-oxide networks in single and hybrid NTMO systems provide significant microstructural enhancement and life cycle stability benefits while providing self-cleaning, antibacterial, thermoelectric, and antiradiation functionalities. Unlike earlier reviews, which were limited to only general nano-materials, this work integrates scattered NTMO studies, quantifies property–dosage correlations, and presents optimization strategies and future research pathways for predictive, data-driven multifunctional, and carbon-neutral geopolymer concretes. This study establishes NTMO-GPC as a next-generation smart material, enabling sustainable and intelligent infrastructure development.</p>