Due to the accumulated fatigue damage in steel–concrete continuous composite box beams, a plastic hinge forms in the negative moment zone, leading to significant internal force redistribution. To investigate the internal force redistribution in the negative moment zone and confirm structural safety under fatigue loading, experimental tests were conducted on nine steel–concrete continuous composite box beams: eight of them under fatigue testing, one of them under static testing. The test results showed that the moment modification coefficient at the middle support increases during the fatigue process. When approaching fatigue failure, an increase of 1.0% in the reinforcement ratio or 0.27% in the stirrup ratio results in a reduction of 13% in the moment modification coefficient. Furthermore, a quadratic function model was proposed to calculate the moment modification coefficient of a steel–concrete continuous composite box beam during the fatigue process, which exhibited good agreement with the experimental results. Finally, we verified the applicability of the plastic hinge rotation theory for steel–concrete continuous composite box beams under fatigue loading.