Stone Mastic Asphalt (SMA) mixtures are widely used in high-capacity road pavements due to their durability and resistance to permanent deformation. However, although electric arc furnace (EAF) steel slag and recycled crumb rubber have been individually investigated as alternative materials in asphalt mixtures, evidence regarding their simultaneous incorporation in SMA mixtures under full-scale construction and real traffic conditions remains limited. Moreover, quantitative environmental assessments are often restricted to simplified or qualitative approaches, with limited reporting of carbon footprint results. This study investigates the combined use of electric arc furnace (EAF) steel slag aggregates and recycled crumb rubber in SMA mixtures, integrating laboratory evaluation with full-scale field application on a high-traffic motorway. Two SMA 11 mixtures were designed and assessed: one incorporating steel slag aggregates as a replacement for natural coarse aggregates, and another combining steel slag aggregates with recycled crumb rubber added through the dry process (0.8% by mixture mass). Laboratory testing included volumetric characterization, moisture sensitivity and rutting resistance, while field validation covered surface macrotexture, skid resistance, executed thickness and interlayer bonding. Both mixtures fully complied with the applicable technical specifications, achieving indirect tensile strength ratios (ITSR) above 90% and wheel-tracking slopes below 0.07 mm/10³ cycles. A simplified comparative life-cycle assessment (LCA), limited to modules A1–A3, showed a reduction in CO₂-equivalent emissions of approximately 2% for the mixture containing steel slag and up to 27% for the mixture combining steel slag and recycled crumb rubber, mainly due to the valorization of industrial by-products and end-of-life tyres. Overall, the results demonstrate the technical feasibility and potential environmental benefits of these SMA mixtures within the defined scope of laboratory verification, short-term field performance and screening LCA. The contribution of this study lies in providing applied evidence from a full-scale motorway intervention, complementing predominantly laboratory-based studies and offering a quantified environmental comparison under consistent methodological assumptions.