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Pile foundation heat exchangers (PFHX) have the potential to significantly reduce the carbon emissions associated with air conditioning for commercial buildings. UK adoption of PFHX, although increasing, is still very low due to the uncertainty about their performance and structural integrity. This study aims to highlight the areas of research that have been conducted and the scope of the work carried out in this area alongside further research on the effect of cyclic temperature variation in clays. This research is recommended in order to produce a framework for responses to a pile foundation operating as a heat exchanger. This is one of the areas identified for further investigation to improve the confidence and reliability of PFHX in order to become a more broadly adopted technology