This paper presents a unified approach on determination of the effective stress range based on equivalent law of strain energy and fatigue damage model, so as to provide an efficient approach for accurately assessing effective fatigue stress of existing bridge under traffic loading. A new theoretical framework to relate variable- and constant-amplitude fatigue is proposed in this paper. Different formulation for calculating effective stress range can be derived by the proposed theory, which include the effective stress range by the root mean square, by Miner's law and a new effective stress range based on the nonlinear fatigue damage model. Comparison of the theoretical results of fatigue damage under the effective stress range of the variable-amplitude stress spectrum and experimental data of fatigue damage under realistic traffic loading has confirmed the validity of the proposed theory. As a way to relate variable-amplitude fatigue data with constant-amplitude data, the effective stress range provides the most convenient way for evaluating fatigue damage under variable-amplitude loading. The proposed theory is then applied to provide an efficient approach for accurately assessing fatigue damage of existing bridges under traffic loading, in which online strain history data measured from bridge structural health monitoring system is available. The proposed approach is applied to evaluate the effective stress range for the purpose of the fatigue analysis of a deck section of a long-span steel bridge-the Tsing Ma Bridge in Hong Kong.