The development of an efficient and sustainable transportation system is crucial for the effective functioning of economies. Concrete, a widely used material for road construction, poses significant environmental challenges. A sustainable alternative is to use alkali-activated concrete (AAC) for road construction. However, the aggregates used in AAC are generally mined, contributing to the negative environmental impact. To address this concern, municipal solid waste incineration (MSWI) ashes, specifically MSWI bottom ash (BA), can be utilised to replace natural aggregates. Thus the construction of pavements using sustainable concrete facilitates its growing demand without burdening the environment. This research focuses on the utilisation of municipal solid waste incineration bottom ash (MSWI BA) aggregates in AAC for potential application in pavements. The study was divided into five phases: aggregate characterisation, mechanical performance evaluation, long-term performance study, microstructure analysis, and life cycle assessment (LCA) analysis. The physical properties of MSWI BA aggregates indicated that the aggregates are porous and weak. Nonetheless, these aggregates showed comparable properties to natural aggregates and can still be used for pavement application. However, the metallic aluminium in the MSWI BA aggregates releases hydrogen gas leading to concrete cracking and swelling, thus, hindering its use in various applications. To address this concern, alkaline pre-treatment using sodium hydroxide solution was employed in this research. An optimal replacement level of 30% was chosen based on the effectiveness of the pre-treatment in removing metallic aluminium and the compressive strength of AAC containing MSWI BA aggregates. In the next phase of the research, the mechanical and long-term performance of AAC with optimum replacement level was evaluated. The results demonstrated that the concrete satisfied the mechanical performance requirements for pavements. However, the freeze-thaw resistance of the AAC was below the norm requirement due to the air voids and associated cracking, which was confirmed through scanning electron microscopy (SEM) and X-ray computed tomography analysis. SEM analysis revealed reactive phases in the MSWI BA aggregates and poor aggregate-matrix bonding for the coarser fraction compared to the finer aggregate fraction, leading to decreased mechanical performance. Despite these findings, the AAC containing MSWI BA aggregates satisfied the majority of the norm requirements, indicating its potential for road pavement application. However, evaluating the environmental impact of adding MSWI BA aggregates in concrete is essential. The life cycle assessment analysis demonstrated that the optimal MSWI BA sample exhibited better environmental effects, indicated by a lower environmental cost indicator value compared to AAC and ordinary Portland cement concrete samples with similar performance. In conclusion, the pre-treatment method utilised in this research is optimal for a replacement level of 30% of gravel with MSWI BA aggregates. The AAC with 30% replacement level meets all the mechanical property requirements stipulated by the norm for pavement application, exhibits good air void distribution, and has limited environmental impact owing to the lower ECI value. This study evaluated the feasibility of applying MSWI BA aggregates in AAC for pavement application and showed promising results.