Integral-abutment bridges have many advantages over full-height-abutment or stub-abutment bridges. Integral abutments eliminate or reduce the number of expansion joints in bridge superstructures and simplify design, detailing, and construction. In this paper, foundation design concepts, such as fixed-head pile, pinned-head pile, hinged abutment, fixed-base pile, prebored hole, sleeved pile, and asymmetry are reviewed. The typical foundation type for support of integral abutments is the steel H pile. Depending on bridge length, skew, and site conditions, other types of foundations, such as precast prestressed-concrete pile, pipe pile (steel encased concrete pile or metal shell pile), timber pile, combined H pile (or W section) and drilled shaft, caisson wall, drilled shaft, sheet pile, and spread footing can be used to support integral abutments. Several design methods and proposed limits for typical integral abutment bridges are reviewed.