The optimization of alternative materials in concrete production continues to garner considerable attention in order to meet sustainability goals and supplement natural materials. Portland limestone cement (PLC) and municipal solid waste incineration (MSWI) bottom ash (BA) have been proposed separately as green cement and coarse aggregate supplement in low-strength concrete production, creating sustainable products and alternative disposal scenario for a waste material. This study discusses the impact of advanced ash processing techniques on aggregates and presents the performance of concrete incorporating both of these products with PLC for the first time. Two sources of MSWI BA were investigated, one as-produced (TMR) and one processed with novel advanced metals recovery (AMR). The AMR process reduced total Al content in ash compared to TMR (20,500 vs 17,000 mg/kg), though not aluminum oxide content, as the AMR process targets metallic aluminum. A composition study on both aggregates supports a reduction in ferrous and non-ferrous metals following the AMR process. All control and test mixes met 28-day compressive strength requirements (17 Mpa). Both AMR and TMR MSWI BA-amended concretes yielded compressive strengths below control specimens (no ash) ranging from 17 to 23 MPa, with little to no difference observed dependent on MSWI BA processing. The life-cycle discussion supports benefits deriving from supplementing naturally mined materials and recovering ferrous and nonferrous metals with the AMR process.