The fatigue damage of orthotropic steel bridge decks is a prominent problem, which is one of the key problems in bridge engineering. Due to the special structure of roof-U rib weld, the stress on this part is complicated under the action of random wheel load, residual stress, welding defects, and other factors, and it has become the key part of the fatigue damage control of steel bridge decks. With respect to the fatigue of roof-U rib weld of orthotropic steel bridge decks, this paper investigated the research status and progress of the fatigue of roof-U rib weld at home and abroad, summarized the fatigue damage characteristics and causes, research methods, and fatigue strength, described the fatigue research and test methods for the structure, and analyzed the fatigue stress characteristics of roof-U rib weld. The typical fatigue crack propagation law of this part was discussed, and the fatigue strength under different failure modes was compared and analyzed based on the fatigue test results. Further, the influence of different failure modes on the fatigue properties was revealed. The results show that there are various fatigue failure modes of roof-U rib weld in steel bridge decks, and there are certain differences in fatigue strength under different failure modes. However, current fatigue studies on this part tend to focus on the overall fatigue performance and lack targeted research on fatigue performance and damage mechanism under specific failure modes. It is difficult to accurately reflect the real fatigue performance of this part.