The failure of bituminous pavements takes place due to heavy traffic loads and weather-related conditions, such as moisture, temperature, and UV radiation. To overcome or minimize such failures, a great effort has been put in recent years to enhance the material properties of bitumen, ultimately improving field performance and increasing the pavement service life. Polymer modification is considered one of the most suitable and by far the most popular approach. Elastomers, chemically functionalised thermoplastics and plastomers * (* Note: notwithstanding the fact that in Polymer Science the word ‘plastomer’ indicates a polymer with the simultaneous behaviour of an elastomer and plastics (thermoplastics), this paper uses the term ‘plastomer’ to indicate a thermoplastic polymer as it is more commonly found in Civil and Pavement Engineering.) are the most commonly used polymers for bitumen modification. Plastomers provide several advantages and are commonly acknowledged to improve high-temperature stiffness, although some of them are more prone to phase separation and consequent storage instability. Nowadays, due to the recent push for recycling, many road authorities are looking at the use of recycled plastics in roads. Hence, some of the available plastomers—in pellet, flakes, or powder form—are coming from materials recycling facilities rather than chemical companies. This review article describes the details of using plastomers as bitumen modifiers—with a specific focus on recycled plastics—and how these can potentially be used to enhance bitumen performance and the road durability. Chemical modifiers for improving the compatibility between plastomers and bitumen are also addressed in this review. Plastomers, either individual or in combination of two or three polymers, are found to offer great stiffness at high temperature. Different polymers including HDPE, LDPE, LLDPE, MDPE, PP, PS, PET, EMA, and EVA have been successfully employed for bitumen modification. However, each of them has its own merit and demerit as thoroughly discussed in the paper. The recent push in using recycled materials in roads has brought new light to the use of virgin and recycled plastomers for bitumen modification as a low-cost and somehow environmental beneficial solution for roads and pavements.