The sensitive surface layer can be used to realize functions of traffic detection, weigh-in-motion, and self-sensing. Hence it plays a role in the digitalization of the pavement infrastructure. Conductive carbon-based additives are reviewed and considered as the best additives to make piezoresistive pavement materials to obtain multifunctionality. However, there exists a research gap in understanding how to realize the three functions mentioned above simultaneously, how to select the raw materials, how to use the sensitive surface layer, and how to balance the performances. In this review, the functional requirements of the sensitive surface layer and the limitations of current technology are specified. The type and dispersion of carbon-based additives are summarized. The laboratory and field applications as well as mechanical and electrical performances of piezoresistive pavement materials are investigated. Finally, the cost analysis and effect of the environment are analyzed. Further studies are needed on the control of additives, the evaluation factors of the electrical properties, as well as on the collection and process of the output data under complex and realistic vehicle and environmental loads. This review can be used to provide extensive information and to explore further development and application of such sensitive pavement technology. More broadly, it can contribute to the digitalization of the transportation infrastructure.