Inverted base pavements involve a well-compacted granular aggregate base built between a thin asphalt concrete layer and a cement-treated base. Inverted base pavements can be constructed using conventional equipment and procedures but require proper quality control. This study reviews the extensive South African experience and case histories in the USA. Accumulating evidence suggests that inverted base pavements are a viable alternative and can outperform conventional pavements at a lower cost. Inverted base pavements rely on the complementary interaction between layers. The cement-treated base provides a stiff foundation for efficient compaction and constrains the deformation of the stress-sensitive granular aggregate base. The thin asphalt surface layer deforms as a membrane and develops low tensile stress. Additional large-scale field tests should be conducted to assess the performance of inverted base pavement designs in a wide range of conditions relevant to the USA.