Post-grouting of piles has become increasingly popular because it significantly enhances axial load capacity at serviceable displacement levels. After pile construction and concrete hardening, grout is injected under pressure beneath the pile tip to improve base resistance. This technique has been widely adopted worldwide, as base-grouted piles can achieve higher tip resistance and increased capacity with relatively small settlements. However, the decision to use post-grouting remains debated due to the additional construction cost. Designers must compare the load–displacement behavior of grouted and ungrouted piles to evaluate its feasibility. This paper reviews current practice in pile post-grouting, evaluates the effectiveness of different improvement mechanisms, and provides recommendations to guide design and implementation based on research findings.