The A22 Colle Isarco Viaduct is one of the most important infrastructural links in Italy, of strategic importance on the European route E45, connecting Northern Europe to Italy. A disruption of this bridge caused by a damage event would result in a critical increase in traffic congestion, with negative consequences for users and environment. To optimize its management after a possible damaging event, we developed an innovative decision support system (DSS), based on the data from a multi-technology structural monitoring system, which includes a robotized topographic system, a fibre optic sensor network and a thermometer network. The DSS analyses the monitoring data, assesses the probabilities that the bridge is damaged or not by using formal Bayesian inference, and identifies the optimal action according to the axioms of expected utility theory (EUT). This DSS is one of the first of its kind developed in Europe and can help in optimizing the traffic management along the A22 highway while enhancing users’ safety and reducing the bridge maintenance costs. It highlights in real time abnormal states of the bridge and allows the owner to act promptly with inspection, maintenance or repair, only when strictly necessary. We developed this DSS in collaboration with Autostrada del Brennero SpA, and although designed for a specific case study, its scope is very broad and can be applied to any problem of infrastructure management which requires optimal decision based on uncertain information under safety and economic constraints.