To date, research on concrete-filled fiber-reinforced polymer (FRP) tubes (CFFT) has focused on the effect of static loads, simulated seismic loads, and long-term sustained loads. Dynamic fatigue behavior of CFFTs, on the other hand, has received little or no attention. This paper reports on an experimental study to evaluate damage accumulation, stiffness degradation, fatigue life, and residual bending strength of CFFT beams. A total of eight CFFT beams with four different types of FRP tube were tested under four point bending. Test parameters included reinforcement index, fiber architecture, load range, and end restraints. Fatigue performance of CFFT beams is clearly governed by characteristics of the FRP tube and its three phases of damage growth: matrix cracking, matrix delamination, and fiber rupture. Lower reinforcement index increases stiffness degradation and damage growth, and shortens fatigue life. End restraints, e.g., embedment of FRP tube in adjacent members, promote composite action, arrest slippage of concrete core, and enhance fatigue life of CFFT beams. It is suggested that a maximum load level of 25% of the static capacity be imposed for fatigue design of CFFTs. With proper design, CFFTs may withstand repeated traffic loading necessary for bridge girders.