In order to investigate influence of T-type rib on flexural fatigue behavior of concrete composite slab with precast prestressed ribbed panel, experiment is conducted to study the concrete composite slab with precast prestressed T-type rib panel and cast-in-place slab. The factors influencing the fatigue failure pattern and fatigue damage, such as T-type rib and fatigue load parameter, are studied by fatigue tests. The dynamic deflection, strains of concrete and prestressed tendons, and residual deflection are measured. Stiffness degradation, strain distribution, crack distribution and residual bearing capacity are analyzed. Results show that composite slabs with precast prestressed T-type rib panel can achieve the same flexural fatigue behavior as cast-in-place slabs. Design formulas for normal section bending fatigue strength of concrete composite slab with precast prestressed ribbed panel are put forward with reference to the four assumptions of traditional prestressed concrete flexural member.