Extrusion-based 3D Concrete Printing (3DCP) is rapidly gaining popularity in the construction industry. Trial projects are now being realized at an increasing rate around the world to test the viability of the technology against real-world requirements. This step, from the ‘simple’ deposition of filaments of self-stable concrete to its application in buildings and structures, with all associated requirements and interfaces, comes with challenges. These range from matching the design intent to the manufacturing capabilities (through structural analysis and approval, and reinforcement) to quality consistency (robustness) on large scale, and compatibility with other materials. In many of these areas, much simply remains unknown due to a lack of experimental data or information from projects where 3DCP has been applied. This paper aims at reducing this knowledge gap by presenting a systematic discussion, based on the analyses of eight realized 3DCP projects from around the world. It was found that the structural application of printed concrete is limited, due to a lack of regulatory framework for expedient approval, as well as limited reinforcement options which require to resort to unreinforced masonry analogies. The application of the technology features a host of practical issues that relate to the print process, material, site conditions, building integration and design – or to the 3DCP technology in general. Although some potential risks, such as shrinkage cracking and quality consistency are generally recognized, the measures taken to mitigate them vary considerably, and are largely based on individual expertise. The actual effectiveness is generally unknown. Finally, it was observed that, while the printing itself is fast, the preparation time is generally considerable. This is partially due to a lack of knowledge amongst professionals. In the practical production of a 3DCP project, three expertise areas are crucial: one for the digital part, one for the machine side, and one for the material side. Thus there is a strong need for educational institutions to develop dedicated training courses and incorporate relevant topics into their curricula.