Cement concrete mix design involves determining the proportions of cement, water, fine aggregate, and coarse aggregate to produce concrete with specified properties like strength, workability, and durability at lowest cost. The key factors influencing mix design include the required compressive strength, type and grade of cement, maximum size of coarse aggregates, grading of aggregates, water-cement ratio, workability, and durability. The water-cement ratio is especially important as it affects the strength, permeability, and workability of the hardened concrete.