Given the importance of overcoming the challenges associated with the management of nonrenewable resources, and to solve the industrial waste stream problems, this article presents the results of fundamental research conducted to assess the rutting and fatigue cracking performance of hot asphalt mixtures with high percentages of by-product aggregates. For this purpose, two full-scale flexible pavement test sections were constructed and tested at the accelerated loading facilities at VTI (Swedish National Road and Transport Research Institute). The accelerated test aimed at evaluating the performance of two developed asphalt mixtures, designated as mix 1 and mix 7, and made up of 98% of industrial by-products (namely, steel slag, foundry sand (WFS), and reclaimed asphalt pavement, in addition to biobased additives). The test sections were constructed in an indoor facility and loaded with a heavy vehicle simulator (HVS) equipped with a half-standard truck axle with dual wheels. The two road sections were constructed using the same construction materials obtained from the same source, as follows: asphalt surface layer of 50-mm thick, 70-mm thick granular base layer, and 160-mm thick subbase layer on top of a 2.6-m thick sandy subgrade soil. Horizontal asphalt strain sensors were embedded in the pavement test sections to assess the mixture's resistance to fatigue and cracking and the laser surface profiler measurements were used to evaluate the rutting performance under controlled testing conditions. For comparison purposes, the long-term rutting developed in the sections paved with mix 1 and mix 7 was compared to the rutting observed in a previous similar HVS test carried out on a 70-mm thick asphalt surface layer section made only with natural virgin aggregates.