Prestressed girders often deteriorate over time due to environmental and man-made stressors, lowering the strength and serviceability of bridge structures. Although structural repairs are implemented to improve the load carrying capacity of the structure, the presence of numerous unknowns leads to high uncertainty in estimating the adequacy of repairs. For instance, the cross-section of the remaining strands, material properties, applied external loads, and workmanship assumptions made throughout the repair process introduce ambiguities when estimating the adequacy of the repairs. This study evaluates the efficiency of re-tensioning repairs of prestressed concrete bridge span girders. The repairs include field splicing, re-tensioning, of deteriorated or damaged strands by torquing a splicing coupler. The evaluation in this study considers component, system reliability, and load ratings while accounting for several uncertainties, such as structural repair, material properties, and external loads. This paper introduces an approach to account for prestressing strands damage and repair uncertainties while also accounting for other uncertainties. In this regard, five cases are studied: as-built, repaired, and three varying degrees of damage cases. First, the distribution for structural demand and capacity accounting for uncertainty in loads, material properties, and repair process is defined for each girder in the prestressed concrete bridge span. In doing so, Monte-Carlo simulation is employed to determine the distributions. Accordingly, the limit state function of the girders is defined from the obtained distributions. Then, the component reliability of each AASHTO (American Association of State Highway and Transportation Officials) Type II girder is calculated from the obtained reliability indices based on the determined limit state functions. Finally, a system reliability model of the span is developed from the component reliability of each girder. Some advantages and disadvantages of using component and system reliability index versus load rating in damaged and repaired prestressed concrete bridge girders are also discussed. Several critical conclusions are made regarding the uncertainties in structural repair, material properties and external loads, and their impact on the load rating and the component and system reliability of the prestressed concrete bridge structure girders.