We have developed a lightweight aggregate (LWA) concrete made by expanding fine sediments dredged from the Shihmen Reservoir (Taiwan) with high heat. In this study, the performance of the concrete and of prestressed concrete beams made of the sedimentary LWA were tested and compared with those made of normal-weight concrete (NC). The test results show that the lightweight concrete (LWAC) exhibited comparable time-dependent properties (i.e., compressive strength, elastic modulus, drying shrinkage, and creep) as compared with the NC samples. In addition, the LWAC beams exhibited a smaller percentage of prestress loss compared with the NC beams. Moreover, on average, the LWAC beams could resist loading up to 96% of that of the NC beams, and the experimental strengths were greater than the nominal strengths calculated by the ACI Code method. This investigation thus established that sedimentary LWA can be recommended for structural concrete applications.