The use of sustainable assessment methods in the UK is on the rise, anticipating the future regulatory trajectory towards zero carbon by 2016. The indisputable influence of sustainable rating tools on UK building regulations conveys the importance of evaluating their effectiveness in achieving true sustainable design, without adversely effecting human health and well-being. This paper reviews indoor air quality issues addressed by UK sustainable assessment tools, and the potential trade-offs between building energy conservation and indoor air quality. The barriers to effective adoption of indoor air quality strategies are investigated, including recommendations, suggestions and future research needs. The review identified a fundamental lack of indoor air quality criteria in sustainable assessment tools aimed at the residential sector. The consideration of occupants’ health and well-being should be paramount in any assessment scheme, and should not be overshadowed or obscured by the drive towards energy efficiency. A balance is essential.