Green roof technology can partially mitigate the adverse effects of urbanization by controlling stormwater runoff, pre-filtering water, minimizing climate change outcomes and reducing heat island effects. However, improvements to current green roof systems and innovative approaches are paramount to advancing environmental benefits and consumer acceptance of this technology. Regular green roofs are hindered by high cost and mass, as well as the incorporation of large amounts of polymers. Hydroponic green roofs (HGRs) require specific setups, maintenance and frequent replacement of plant-growing substrate, with limited energy savings in the heating and cooling load of the building due to the space between the roof surface and the hydroponic setup. In this review, a comparison of regular and HGRs is provided, and research into the environmental benefits of these technologies, including stormwater control, water purification and lifecycle assessment, is summarized. Following this, the prospect of porous concrete (PC), as a combined plant-growth substrate and structural layer in a novel extensive hydroponic green roof (EHGR) design is proposed, through a compilation and analysis of recent studies reporting the feasibility of this construction material for different applications. The mechanical, hydrological and vegetative properties of PC are discussed. Finally, a new green roof system that incorporates both PC and hydroponics, termed the EHGR system, is presented. This new green roof system may help offset the effects of urbanization by providing stormwater and pollution control, runoff delay and physical and thermal benefits, while concurrently producing biomass from a reusable substrate.