Maintaining rural cement concrete pavement is essential for long-term performance and traffic safety. This study examines the X034 Road (Nanning Port–Zhangcun Section) in China, assessing pavement conditions using the Pavement Surface Condition Index (PCI) and Riding Quality Index (RQI). The results indicate severe damage, including shattered slabs, cracks, mud pumping, and exposed aggregate. A practical and low-cost maintenance strategy is proposed. Emergency repairs address critical damage, while corrective measures such as crack sealing and slab replacement prevent further deterioration. Preventive maintenance, including surface treatments and drainage improvements, extends pavement lifespan. Additionally, innovative materials like polymer-modified concrete and rapid-curing repair compounds enhance durability and efficiency. This study emphasizes economical and feasible inspection and maintenance approaches for rural roads.