Vapor intrusion (VI) is a term used to describe indoor air (IA) contamination that occurs due to the migration of chemical vapors in the soil and groundwater. The overall vapor transport process depends on several factors such as contaminant source characteristics, subsurface conditions, building characteristics, and general site conditions. However, the classic VI conceptual model does not adequately account for the physics of airflow around and inside a building and does not account for chemical emissions from alternative "preferential" pathways (e.g. sewers and other utility connections) into IA spaces. This mini-review provides information about recent research related to building air exchange rates (AERs) and alternative pathways to improve the accuracy of VI exposure risk assessment practices. First, results from a recently published AER study for residential homes across the United States (US) are presented and compared to AERs recommended by the US Environmental Protection Agency (USEPA). The comparison shows considerable differences in AERs when season, location, building age, and other factors are considered. These differences could directly impact VI assessments by influencing IA concentration measurements. Second, a conceptual model for sewer gas entry into buildings is presented and a summary of published field studies is reported. The results of the field studies suggest that alternative pathways for vapors to enter indoor spaces warrant consideration. Ultimately, the information presented in this mini-review can be incorporated into a multiple-lines-of-evidence approach for assessing site-specific VI exposure risks.