This paper summarizes the current state of practices on the use of design review boards, or consuling boards, as used primarily during design of underground construction projects. It discusses the various types of boards in use and reviews the history, and then, using the results of an industry survey of both owners and consultants, it discusses the purposes and typical uses, provides examples of specific outcomes, and reviews the methods of selection and modes of operation. It summarizes the advantages and disadvantages, evaluates the use of the construction manager to provide design review, and provides recommendations for future users based upon the lessons learned to date.