The integration of Lean, Green, and Industry 4.0 (I4.0) technologies has emerged as a crucial focus in the pursuit of enhanced efficiency and sustainability in the construction industry. In particular, the Mechanical, Electrical, and Plumbing (MEP) systems, which are fundamental components of modern construction projects, stand to benefit significantly from the application of these advanced frameworks. However, despite the growing body of literature exploring Lean and Green principles as well as I4.0 technologies, the specific intersection of these concepts within MEP construction remains underdeveloped. This paper aims to address this gap by conducting a systematic literature review that critically examines the integration of Lean, Green, and I4.0 technologies in MEP construction. By analysing existing studies and identifying synergies and challenges, this review seeks to provide a comprehensive understanding of the current state of research and to propose pathways for future development in this area.