ACI ITG-4.3R presents a literature review on seismic design using high-strength concrete. The document is organized in chapters addressing the structural design of columns, beams, beam-column joints, and structural walls made with high-strength concrete, and focuses on aspects most relevant for seismic design. Each chapter concludes with a series of recommended modifications to ACI 318-05 based on the findings of the literature review. The recommendations include proposals for the modification of the equivalent rectangular stress block, equations to calculate the axial strength of columns subjected to concentric loading, column confinement requirements, limits on the specified yield strength of confinement reinforcement, strut factors, and provisions for the development of straight bars and hooks.