ICUs have been extensively studied regarding the role of the built environment in issues of patient safety and infection control, patient-staff outcomes, and the interventional role of the physical environment. The results of this comprehensive literature review (2005-2020) demonstrate an increase in design of single-bed ICUs, increase in the engagement of families in the ICU experience, acknowledgement of improving caregiver well-being, performance through designing staff amenities, increased attention to the therapeutic role of exposure to nature and lighting, and increased pandemic concerns related to containment of the COVID-19 virus.