This paper compares key performance indicators (KPI) for infrastructure sustainability in the United States and China. The paper also discusses the implications and challenges of addressing sustainability and sustainable development in the two countries. The research shows that there are noticeable differences in the indicator system structure, although there is general agreement on the concrete sub-indicators. These differences are closely linked to the research method, theory of the respective country and the macro-level priorities in formulating their sustainable development agenda. The America KPIs system was set up by Delphi method, while the Chinese one was based on complicated systematical theory and systematical ecology. The most significant agreements are on sub-indicators related to ecology, economy, project management and administration. However, there are significant disagreements on some indicators related to special indicators of highway systems. The contribution of this paper provided empirical evidence of such underlying differences. Based on the comparison of the two KPIs systems, further research is suggested to validate the indicators and the structure for infrastructure sustainability.