A great amount of highway bridges is reaching the lifespan for which they were designed, and most of them need frequent inspections and maintenance to guarantee the safety of users. Structural health monitoring can help infra-structure operators to estimate promptly and accurately the structures’ health condition. The progress of technology has encouraged the develop-ment of modern non-destructive monitoring techniques, such as the acoustic emission (AE) method. Recent experiences testify its potential, especially applied to the detection of cracks’ initiation and propagation in structures where it is difficult to perform visual inspection or direct measurements. In this paper, we analyze and correlate the results of AE techniques with the in-itiation and propagation of damage in a full-size prestressed concrete high-way bridge subjected to a load test up to its failure: the Alveo Vecchio Via-duct. The bridge, built in 1968 and regularly maintained over the years, is representative by type, age, and deterioration state of similar bridges in oper-ation on the Italian highway network. We aim to identify the differences in AE recorded on a real-life structure before and after the first-crack opening, and more in general, the effectiveness of AE techniques in permanent or short-term monitoring.