Construction in developing urban areas implies use of construction materials from quarries and excavation of soil and rock. From a resource perspective, there could be benefits from using excavated soil and rock as a construction material. The aim of this paper is to describe the material flow and management practices of urban excavated soil and rock from the perspective of resource efficiency. A conceptual model for the urban flow of excavated soil and rock was developed and a literature review concerning the management of excavated soil and rock was conducted. The conceptual model was subsequently used to clarify the different perspectives of the scientific literature and knowledge gaps. Conclusions drawn are that there is little knowledge about the quantities and the fate of excavated soil and rock in urban regions. Current research is focusing on the waste flows of construction material and little is known about the overall management practices of excavated soil and rock. Clearly, excavated soil and rock are often disposed at landfills and the recycling rate for high quality purposes is low. There is a need to evaluate the potential for an increased use of excavated soil and rock as construction material. However, the overall efficiency of urban construction material management can only be evaluated and improved by also including construction materials produced in quarries.