Properly designed and constructed concrete pavements should provide a serviceable life of 50 years or more without the need for major rehabilitation and with only minimal maintenance interventions required. The main challenge to achieving this outcome is construction quality. We frequently see recently constructed concrete pavements develop cracking that can eliminate the economic benefit of having constructed with concrete in the first place. In the case of airfield pavements, the early onset of distresses can be much more serious than in the case of highway pavements but in all cases it has significant economic impact in terms of maintenance expenditures, and on operational safety. While it is not unexpected to have early age plastic shrinkage cracking in concrete pavements and it is recognized as not representing a severe distress, this type of cracking can be eliminated with appropriate concrete mix design, strictly adhering to best practices for concrete placement, finishing and curing. However, the main challenge is the development of premature structural cracking that, once it occurs is very difficult to repair and thus needs to be avoided, where possible. Unfortunately, it occurs frequently. Based on case studies, this paper will explore the range and types of early age distresses that all too frequently occur in even properly designed concrete pavements. By identifying the causes of these distresses, the means for avoiding them becomes clear. The investigation included innovative methods of concrete pavement support such as Ground Penetrating Radar and Electro Magnetic EM-31 surveys to identify support anomalies. The lessons learned point to the imperative of achieving uniform pavement support for concrete pavements, of managing and coping with adverse construction conditions, and having in place the appropriate level of independent quality assurance inspection and testing during all critical stages of construction.