Using a mechanically stabilized earth (MSE) wall as a bridge abutment has become an attractive option to the traditional cast-in-place wall abutment. The use of an MSE wall abutment notably simplifies the design and construction of the bridge abutment, requires less site preparation, allows faster construction, and consequently leads to cost saving. The poor performance of an MSE wall may be related to construction conditions, the wall materials, and poor soil below the foundations. In this paper, the results of a large-scale inspection program are analyzed to identify the most frequent MSE wall problems, and a new inspection rating system procedure is proposed. This paper also presents a risk assessment method to determine the overall rating of the MSE wall after inspection and suggests a course of action. Finally, the paper presents recommendations for the design and construction methods to avoid future problems.