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This chapter outlines complex and conflicting issues related to designing tall buildings. It gathers a vast amount of fragmented criticism and concerns and organizes them around the three pillars of sustainability: social, economic, and environmental. Mapping out the “unsustainable” aspects forms the foundation for addressing them in future research and tall building developments. The chapter engages the reader with a preliminary discussion on potential solutions to the outlined problems. It also balances extensive criticism by highlighting the virtues and advantages of tall buildings. Consequently, this chapter forms a foundation for improving the sustainability of tall buildings whenever and wherever they are constructed.