To address the issue of insufficient transverse connectivity in prestressed concrete box girder (PCB) bridges, this study investigates two transverse strengthening methods—installing diaphragms and utilizing concrete-filled steel tube trusses (CFSTTs). A finite element model was developed for a typical 30 m PCB bridge and was validated by on-site load test results for reliability. Based on the deflection and load distribution of PCB bridges before and after reinforcement, as well as the maximum stress and strain of the diaphragms and the CFSTTs, comparative analyses were conducted on diaphragms of different thicknesses and materials, as well as on CFSTTs of various strength grades. The results show that the addition of a transverse partition and CFSTTs can effectively improve the load distribution of the PCB bridge and reduce the maximum deflection of the girder, especially when using the CFSTT reinforcement method. The unique structural design improves the reinforcement effect of the material in the post-elastic stage. When using CFSTTs, increasing the steel tube wall strength significantly reduces the maximum deflection of the main girder. For example, using steel tubes with yield strengths of 235 MPa and 420 MPa filled with concrete of 50 MPa compressive strength reduced the maximum deflections by 15.32% and 24.55%, respectively, and improved the load distribution coefficients by up to 7.31% and 11.57%. Additionally, steel diaphragms demonstrated better reinforcement effects compared with concrete diaphragms. The load transverse distribution coefficients for the CFSTT-reinforced PCB bridge were calculated using the hinge plate (beam) and the rigid plate (beam) methods, showing minimal differences between the two approaches. The findings of this study provide valuable insights into the design of diaphragm and CFSTT reinforcement in PCB bridges, aiding in the selection of optimal reinforcement strategies.