This paper documents engineering design and material considerations and lessons learned for four concrete rehabilitation strategies considered at the Lambert-St. Louis International Airport. The following four options were evaluated for repairing the distressed concrete slabs located on the keel section of Runway 12L-30R: 1. Removing and Replacing PCC panels under nightly 7-hour closures utilizing full depth cast-in-place fast setting concrete. 2. Removing and replacing PCC panels under nightly 7-hour closures utilizing partial depth precast panels. 3. Removing and replacing the runway keel section under weekend closures utilizing a partial depth PCC inlay. 4. Removing and replacing the runway keel section under weekend closures utilizing full depth PCC removal and replacement. The final method selected for the rehabilitation was the full depth removal and replacement option (#4) based on operational constraints, construction methods, and contractor considerations. The other design alternatives are included in the paper to allow designers of similar projects to benefit from the development of the four strategies and significantly shorten their learning curve when considering rehabilitation strategies for operationally critical PCC pavements.