This paper presents a comprehensive overview of recent developments in the performance evaluation and flexural response of existing bridges from fundamental concepts to advanced topics. The focus is particularly on the structural evaluation to enhance the quality assessment of constructed bridge superstructures, taking into account a synthesis of the most important contributions to the flexural behavior of existing bridges, such as dynamic responses and lateral load distributions. This state-of-the-art paper provides a critical review of published literature and existing assessment methodologies in conjunction with corresponding analysis techniques, including technical comments on the code provisions. Detailed descriptions of the important parameters influencing flexural responses of existing bridges are discussed, such as the geometric effect, loading configuration, present condition of a bridge, and contribution of secondary structural elements. The review also includes the investigation methodologies, namely, the diagnostic and proof load tests. Finally, the current research needs to further advance the performance evaluation technologies for existing bridge superstructures are recommended. DOI: 10.1061/(ASCE)CF.1943-5509.0000007 CE Database subject headings: Bridges; Bridge maintenance; Evaluation; Load distribution; State-of-the-art reviews; Flexural strength.