Stakeholders in the pavement sector have been seeking new engineering solutions to move towards more sustainable pavement management practices. The general approaches for improving pavement sustainability include, among others, reducing virgin binder and virgin aggregate content in hot mix and warm mix asphalt, reducing energy consumed and emissions generated in the mixtures’ production, applying in-place recycling techniques, and implementing preventive treatments. In this study, a comprehensive and integrated pavement Life Cycle Costing-Life Cycle Assessment (LCC-LCA) model was developed to investigate, from a full life cycle perspective, the extent to which several pavement engineering solutions (hot in-plant recycling mixtures, warm mix asphalt, cold central plant recycling and preventive treatments) are most efficient at improving the environmental and economic aspects of pavement infrastructure sustainability, when applied either separately or in combination, in the construction and management of a road pavement section located in Virginia, US. Furthermore, in order to determine the preference order of alternative scenarios, a multi-criteria decision analysis method was applied. The results showed that the implementation of a recycling-based maintenance and rehabilitation strategy where the asphalt mixtures are of type hot mix asphalt containing 30% RAP best suits the varied and conflicting interests of stakeholders. This outcome was found to be robust even when different design and performance mixtures and treatment type scenarios were considered.