Although alkali-activated materials (AAMs) show great promise as viable substitutes for Ordinary Portland Cement (OPC), they face numerous challenges in achieving widespread market acceptance. These challenges include the intricate chemistry of AAMs, technological and environmental complexities, inconsistency in the availability and quality of raw materials, and the absence of a well-established value chain for AAM production. Furthermore, legislative and regulatory frameworks are often lacking or unfavorable, and economic concerns related to scalability and competitiveness continue to pose barriers. Social acceptance remains limited, often due to unfamiliarity with the material and skepticism about its long-term performance. This chapter presents findings from various international research and development projects focused on advancing AAM technology. It highlights the pivotal role of pilot-scale trials in assessing the feasibility of AAM implementation, identifying technical and logistical challenges, and guiding further innovation. Additionally, the chapter showcases successful case studies and industrial applications of AAMs, positioning them as sustainable, high-performance alternatives to both traditional OPC and ceramic-based construction materials.