Aging of the bridge infrastructure inventory has caused Department of Transportation agencies to critically focus on bridge preservation and replacement needs, while often faced with constrained or reduced budgets every year. A strategic bridge preventive maintenance program has been shown to be an effective way to preserve and extend bridge service lives. A bridge preventive maintenance program is related to routine practices that are repeated with some particular frequency to obtain the best results. Moreover, it is well known that frequently performing less-costly preventive maintenance activities results in a more efficient alternative than performing fewer expensive repairs/rehabilitation or even replacements of bridge elements. The objective of this research was to review bridge maintenance activities recommended by specialized literature, to examine maintenance activities currently conducted by the various INDOT districts, and also to review maintenance activities performed by several other DOT agencies. Based on the results of this review, a list of ten new and enhanced bridge preventive maintenance activities was identified to improve the effectiveness of bridge maintenance operations in Indiana. The required conditions and frequency to perform each activity was analyzed, and the cost and benefit of such operations was studied to ensure that the proposed activities are economically feasible and sustainable.