It is well-known fact that air conditioning systems are responsible for a significant part of all energy systems in building energy usage. In EU buildings, the building HVAC systems account for ca 50% of the energy consumed. In the U.S., air-conditioning accounts on average about 12% of residential energy expenditures. The proper choice of air distribution systems and sustainable energy sources to drive the electrical components have a vital impact to achieve the best requirements for indoor climate including, hygienical, thermal, and reasonable energy-saving goals. The building energy system components that have a considerable impact on the demand for final energy in the building are design, outdoor environment conditions, HVAC systems, water consumption, electrical appliances, indoor thermal comfort, and indoor human activities. For calculation of the energy balance in a building, we need to consider the total energy flows in and out from the building including ventilation heat losses, the perimeters transmission heat loses, solar radiation, internal heat from occupants and appliances, space and domestic water heating, air leakage, and sewage heat losses. However, it is a difficult task to handle the above time-dependent parameters therefore an energy simulation program will always be used. This chapter aims to assess the role of ventilation and airconditioning of buildings through the sustainability approaches and some of the existing renewable energy-based methods of HVAC systems are presented. This comprehensive review has been shown that using the new air distribution systems in combination with renewable energy sources are key factors to improve the HVAC performance and move toward Nearly Zero Carbon Buildings (NZCB).