Since the 1960s, orthotropic deck plates of highway bridges have been built with large cold-formed trapezoidal stiffeners supporting a deck plate with a thickness of approx. 12 mm. The maximum cross-beam spacing is approx. 4 m. A number of these bridge decks in The Netherlands suffer from fatigue cracks in the deck plate. First cracks have been observed after about 30 years in service. In one particular movable bridge, the cracks were found after only seven years. In many other countries, this type of crack has not yet been observed. This article provides a fatigue assessment procedure for deck plates. The procedure is calibrated with the conditions and observations in The Netherlands. It gives a fatigue life prediction and takes account of inspection results quantitatively. Although aspects such as the type and thickness of the surface finishes and the traffic load may vary between countries, the principles of the assessment procedure in this article are generally applicable and can be used to identify reasons for differences in fatigue life and to develop strategies for increasing the life.