During the past 25 years, a rather rapid evolution has taken place in the design and use of prestressed concrete reactor vessels (PCRVs). Initially the concrete vessel served as a one-to-one replacement for its steel counterpart. This was followed by the development of the integral design which led eventually to the more recent multicavity vessel concept. Although this evolution has seen problems in construction and operation, a state-of-the-art review which was recently conducted by the Oak Ridge National Laboratory indicated that the PCRV has proven to be a satisfactory and inherently safe type of vessel for containment of gas-cooled reactors from a purely functional standpoint. However, functionalism is not the only consideration in a demanding and highly competitive industry. A summary is presented of the important considerations in the design and analysis of multicavity PCRVs together with overall conclusions concerning the state of the art of these vessels.