This paper presents a method to assess the load transfer efficiency (LTE) of concrete pavement joints using distributed optical vibration sensors. First, a theoretical analysis of concrete pavement vibration was conducted to investigate how to reflect LTE by spectral amplitude. Second, distributed optical vibration sensor (DOVS) was applied to measure vibration around joints distributedly. Third, the corresponding processing method for DOVS data was proposed to calculate the ratio of spectral amplitude from different slabs through power spectral density (PSD) analysis. Then, field tests were conducted on nine concrete pavement slabs with three different types of joints (dummy joint, rabbet joint, and dowel bars). The deflection-based method as well as the proposed vibration-based method were employed to assess the LTE of eleven joints on two different dates. The comparative analysis results indicate the deflection-based LTE (DLTE) and the ratio of PSD (RPSD) have a strong correlation (0.871) and a slight difference (<±0.03) overall. The correlation is robust in different dates and types of joints (0.844~0.88). These findings prove the accuracy and effectiveness of the proposed vibration-based method.