Mastic asphalt (MA) has been particularly popular in recent years for bridge pavements due to many advantages such as easy application, good waterproofing properties, and high durability. However, the drawback of mastic asphalt in comparison to other asphalt mixtures is its lower resistance to permanent deformation. Trinidad Lake Asphalt (TLA) is often applied to make mastic asphalt resistant to permanent deformation. Practical experience demonstrates that serious failures may occur if MA pavement design and materials selection is not taken into account sufficiently. Therefore in this study, the influence of two parameters: zero shear viscosity (ZSV) of TLA-modified binder and mastic composition described by the filler–binder ratio, on the permanent deformation resistance of the MA mixture was evaluated. The primary purpose of determining the ZSV of the TLA-modified binders was to evaluate the rutting potential of the binders. The permanent deformation (rutting) resistance of the MA mixtures was evaluated based on static and dynamic indentation tests. The optimum content of TLA in the base bitumen and the optimum filler–binder ratio in the MA mixture were obtained based on multiple performance evaluations for modified binder, mastic and MA mixtures, i.e., 20% and 4.0, respectively.