This paper presents a case study of geotechnical design and construction challenges of bridge foundations and approaches in a hilly granite formation in northern New South Wales, Australia. Firstly, the geological formation and existing cut slope conditions which have high risks of rock fall is described. The detailed design was based on the available geotechnical information and assumed construction methodology. Reinforced concrete cantilever retaining walls founded on mass concrete were adopted for the bridge southern approach to resolve constructability issues over hilly terrain. Slope treatments using a rock fall fence together with individual boulder stabilisation or removal were also considered. It was found during construction that the actual ground conditions were different to that originally inferred and modifications to pad footing designs were deemed necessary. Additional investigations were undertaken, and the subsurface ground models updated to inform the revised design. For the northern bridge abutment foundation, a piled foundation was introduced to optimise the design with due consideration of temporary piling platform and access along a new geotextile reinforced approach embankment. The revised design was developed in close collaboration with the Contractor and the Principal. The foundation design of Pier 2 was revised using micro-piles to address the presence of a weak rock layer intrusion. In the end, key lessons learnt from this challenging project have been summarised for future project references.