Curved composite twin-girder bridges are suitable for mountainous areas, due to their advantages of light self-weight, excellent mechanical performance, and fewer construction requirements. It has been found that many composite twin-girder bridges collapsed due to fatigue failure. However, the literature review showed no relevant studies on the fatigue performance of curved composite twin-girder bridges. Because of this, the specimen of 1:2 scale curved composite twin-girder bridge in accordance with the design scheme of Xizhen Bridge in China was designed and tested. Three possible fatigue details were selected: cruciform connections, transverse attachments, and transverse splices named Class I, Class II, and Class III. For the test data of nominal stress (NS), equations were proposed to convert the strain value into the internal force of the fatigue detail position. The stress caused by torsion accounts for 2.8% of the total stress, which is almost negligible. The fatigue evaluation process based on the hot spot stress (HSS) S-N curve method is presented. The HSS method is more conservative than the NS S-N curve method in predicting the fatigue life of complex structures with high-stress concentrations.