Conventional testing of physical salt attack (PSA) on concrete does not consider concomitant factors that may exist in service and alter the mechanisms and kinetics of PSA. This study adopted a combined testing approach where concrete was concurrently investigated under accelerated PSA and carbonation, simulating elements serving in heavy traffic and industrial zones, while implementing ambient conditions similar to that in geographic locations with previous cases of PSA. Based on the tested mixture design parameters [water-to-binder ratio, cement type, and supplementary cementitious materials], potential performance improvement and risks were identified. Thermal, mineralogical, and microscopy analyses elucidated the co-occurrence of complex degradation processes in concrete subjected to accelerated PSA and carbonation, which were distinctive from that induced by the single-factor PSA exposure. The synoptic results from this study may informatively improve guidance on mixture design of concrete when dual exposure to PSA and carbonation is expected in the field.