The construction industry is embracing sustainable building practices that boost the “triple bottom line”, namely the building's ecological, social, and financial performance. Since more than 55 million US students spend a significant part of their day in K-12 schools, it is vital that these facilities should provide healthy, comfortable, and productive learning environments. Here we present an in-depth literature review of how educational facilities affect student school performance, comfort, and health, and we examine the role of sustainable design and construction strategies in influencing the physical learning environment in schools. Significant barriers to implementing sustainable strategies are examined, particularly the first cost premium of a sustainable building. A systematic decision strategy is described that incorporates sustainable design strategies, lowering energy consumption and improving indoor environments. A case study describes the process of incorporating sustainable strategies in a K-12 education facility in North Carolina to lower annual energy consumption and greenhouse gas emissions. Ways to reduce the first cost premium and minimize operating costs over the facility's life while providing healthy and comfortable learning environments for students and teachers are discussed. The case study school also functions as an experimental learning tool for teaching sustainability to K-12 students, having the potential to improve their attitudes and behavior with respect to sustainability.