In this study, experiments were conducted on the freeze–thaw performance of manufactured sand cement concrete with different sand ratios and fly ash contents. The research found that during 200 freeze–thaw cycles, as the fly ash content increased, the concrete exhibited a higher mass loss rate and a decline in the relative dynamic modulus of elasticity. This was due to the lower activity of SiO2 and Al2O3 in the fly ash, which reduced the hydration products. Incorporating an optimal amount of manufactured sand can increase the density of concrete, thereby improving its resistance to freeze–thaw cycles. However, when the content of manufactured sand was high, its large surface area could interfere with the hydration process and reduce strength, thereby diminishing the freeze–thaw resistance of the concrete. Given that studying the freeze–thaw resistance of manufactured sand concrete is time-consuming and influenced by many factors, a prediction model based on a BP (back propagation) neural network was developed to estimate the mass loss rate and the relative dynamic modulus of elasticity following freeze–thaw cycles. After validation, the model was found to be highly reliable and could serve as a foundation for mix design decisions and freeze–thaw performance prediction of manufactured sand cement concrete.