The present study compared the effectiveness and cost-effectiveness of four pavement treatments, including hot in-place recycling, milling and filling, thin HMA overlay and microsurfacing. The multiple regression analysis was employed to investigate the effectiveness of treatments and the effect of pretreatment rutting severity and traffic conditions on maintenance effectiveness. The rutting depth (RD) was selected as a performance indicator. The reduction of RD degradation rate and increase in average RD over monitoring period were used as measures of treatment effectiveness. Life-cycle cost analysis was performed to evaluate the treatment cost-effectiveness over a 50-year analysis period. Results indicate that the hot in-place recycling possesses the highest effectiveness and cost-effectiveness. Using reclaimed asphalt pavement (RAP) at appropriate maintenance timing substantially benefits for restoring the rutting resistance of asphalt pavement. These findings provide project agencies with quantitative evidence to support the establishment of the rutting-based maintenance decision-making system and the utilization of RAP in the sustainable pavement management strategies.