Developing a unified analytical framework to assess the structural performance of deteriorated prestressed concrete (PC) girder bridges is important for their maintenance. This study aims to construct a physics-based digital twin framework for PC girder bridges incorporating Bayesian model selection and updating, a high-fidelity three-dimensional (3D) finite element (FE) model, and a method for simulating prestressed tendon damage. In this study, three PC girder specimens were designed and tested to evaluate the effects of tendon rupture near the anchorage region on structural performance. Bayesian model selection was used to determine the most plausible model class based on the estimated model evidence. The most probable values (MPVs) of the model parameters, derived from the estimated posterior probability density functions (PDFs), were then used to calibrate the FE model, which reflects a healthy state of the PC girder bridge. This updated FE model serves as the baseline for conducting what-if scenario simulations. Subsequently, nonlinear segments of the constitutive model, obtained from coupon tests, and a simulation method for tendon rupture were incorporated into the updated FE model. Nonlinear static simulation results obtained through the updated model were found to be consistent with both the observed crack pattern and the load–deflection curve. The reliability of the digital twinning FE model for assessing tendon damage and for predicting the residual load-bearing capacity was verified through comparison with measured data. Therefore, the digital twinning Bayesian model updating approach shows potential applications in continuous structural health monitoring (SHM) of PC bridges.