In the broader context of the ecological transition, it is essential to identify solutions that ensure indoor environmental quality encompassing thermal, visual, acoustic, and indoor air quality conditions to safeguard occupant health and well-being. These solutions should also meet the demand for energy-efficient buildings. With specific regard to thermal environments, a distinction must be made between residential and non-residential settings, where comfort conditions can be achieved, and industrial environments, where thermal stress—and consequently health risks—may arise. To evaluate the quality of a thermal environment, key metrics are necessary. These include the Predicted Mean Vote (PMV) for thermal comfort, Predicted Heat Strain (PHS) and the Wet Bulb Globe Temperature (WBGT) for hot environments, and Required Insulation (IREQ) for cold environments, all governed by ISO-EN standards. The use of indices in residential and non-residential buildings outlines two critical challenges. The first relates to the fact that, in certain instances involving non-air-conditioned buildings, conditions can be borderline between comfort and thermal stress, which must be accurately identified. Secondly, the application of indices frequently neglects necessary variables, disregarding the fundamental limitations and operational boundaries inherent to both objective and personal input quantities. Moreover, the use of measurement devices inconsistent with the minimum requirements laid down by the standards in the field results in unwanted biases with unforeseeable consequences. This review explores the formulation, use, and limitations of the four indices mentioned, providing a perspective on their future development. It establishes the criteria for reliable long-term assessments of thermal and energy environments, encompassing the analysis of both hot and cold strains.