The alkali-aggregate reaction (AAR) in concrete occurs when alkalis from cement react with reactive minerals in aggregates, leading to swelling and possible cracking of structures. There are two main types: alkali-silica reaction (ASR) and alkali-carbonate reaction (ACR). Prevention methods include using low-alkali cement, testing aggregates, and utilizing chemical admixtures, while repair involves assessment, removal of damaged concrete, and application of repair materials.