A steady traffic growth has posed a threat to the fatigue safety of existing bridges. Uncertainties in traffic flows add to the challenge of an accurate fatigue safety assessment. This article utilizes a stochastic traffic load model to evaluate the fatigue reliability of orthotropic steel bridge decks. The traffic load model is simulated by site-specific weigh-in-motion measurements. A response surface method is presented to solve the time-consuming problem caused by hotspot stress simulations in the finite element model. Applications of the stochastic traffic load model for probabilistic modeling and fatigue reliability assessment are demonstrated in the case study of a steel box-girder bridge. Numerical results indicate that the growth rate of the gross vehicle weight leads to a rapid decrease of the fatigue reliability in comparison to the traffic volume growth. Even though the traffic volume growth is rapid, the control of overloaded trucks in comparison to the traffic volume is an effective way to ensure the fatigue safety of the steel bridges.