Sand, gravel, and crushed stone are the most mined materials on Earth. Aggregates constitute the foundation for modern civilization and are essential for providing shelter, infrastructure, and communication, but are an increasingly scarce resource. Here, we review the interconnections between the impacts of aggregate mining and the services they provide. We show that the conflicting impacts on the environment and humankind disrupt the net positive effects of aggregate mining on sustainable development. Focusing on low- and middle-income countries, we link these interconnections to the United Nations Sustainable Development Goals and identify critical obstacles to a sustainable future for global aggregate resources. Our assessment identifies an urgent need to improve knowledge on: (1) direct and indirect impacts of extraction on human health, (2) system-level impacts on ecosystems and the services they provide, and (3) how to meet the projected trajectories of global aggregate demand.