[6] The project broke ground on September 24, 2021, while construction of the expressway was yet to start, pending the approval of its Environmental Compliance Certificate (ECC).

Three segments are planned, in addition to utilizing the portion of the Skyway Stage 3 from Plaza Azul (Nagtahan) to San Juan River in Manila.

It would turn to the land in Paco, where it is proposed to use the right-of-way of Paz Mendoza-Guazon Street and Quirino Avenue before meeting Skyway Stage 3's Nagtahan Exit at Plaza Azul.

In December 2023, a column in The Philippine Star stated that Ramon Ang had decided to drop the proposed Pasig River Expressway project due to public criticism.

According to the Toll Regulatory Board Executive Director Alvin A. Carullo, the P81.53-billion PAREX "is still on the table" for further evaluation in its final engineering design process.

[24] Advocates also pointed out that constructing more new roads would only worsen traffic congestion by attracting more vehicle use, thus decreasing mobility in a phenomenon called induced demand.

[28] Labor lawyer Luke Espiritu and environmentalist David D'Angelo, both under the senatorial slate of Partido Lakas ng Masa, have also called for rejecting the project.

Advocates also noted the absence of key agencies such as the National Commission for Culture and the Arts, the National Historical Commission of the Philippines, the Department of Tourism, the Department of Science and Technology, and the Philippine Institute of Volcanology and Seismology at the previous public scoping, declaring the need to hold a new public scoping meeting that would have included the inputs of the mentioned agencies.

[33] Mobility advocates also questioned Ang's mention of including a bus rapid transit system, bike lanes, and pedestrian infrastructure in response to criticism, as these features were not detailed in the project's EIA report.

[33] Environmental architect Paulo Alcazaren also agreed that the elevated nature of the proposed bus rapid transit system, bike lanes, and pedestrian infrastructure would pose accessibility and connectivity issues.

Palafox has also responded to the criticism, denying that the expressway would only cause additional congestion if built, believing there is an "unmet demand" for an east-west transportation corridor.

[16] Palafox's involvement with the project has also been seen as a complete reversal of his long-standing principles for revitalizing decades of urban decay in Metro Manila with sustainable practices.