<p>Based on a case study of a fractured rock-socketed pile in a bridge adjacent to a deep excavation, this paper proposes an integrated detection method for assessing existing bridge pile foundations. The method comprises three stages: (1) rapid evaluation of pile bearing performance using the dynamic stiffness method; (2) non-destructive testing (NDT) of pile integrity via in-hole low-strain integrity testing and cross-hole elastic wave computed tomography (CT); and (3) verification of pile deformation and fractures through pile coring, borehole camera imaging, and elastic wave techniques. This methodology was applied to the case study, analyzing the sensitivity of NDT techniques to defects such as fractures. Results demonstrate that the comprehensive approach enables thorough, precise, and efficient integrity assessment of existing bridge piles, particularly in spatially constrained environments. More severe pile defects correlated with greater reductions in dynamic stiffness—specifically, the observed fractures resulted in an approximately 35% reduction. Cross-hole elastic wave CT effectively visualized pile deformation and internal wave velocity distribution, enabling high-coverage detection of circumferential cracks and casting defects. The in-hole seismic wave method accurately identified pile fractures and localized defects through multi-path stress wave propagation. The tube-wave method effectively detected casting defects but showed limited sensitivity to fine structural cracks.</p>