In order to achieve the recycling and utilization of solid waste, iron ore tailings were partially replaced with fine aggregates and added with PVA fibers to prepare PVA-iron ore tailings concrete with good workability. The influences of different iron ore tailings replacement rates and PVA fiber content on the flexural performance of concrete were studied through standard flexural tests. The result show that when the PVA fiber content is 0% and 0.1% (mass fraction, the same below), the specimens undergo through type brittle cracking failure. When the PVA fiber content is 0.2% and 0.3%, the crack width of specimens significantly decreases and does not penetrate. When the iron ore tailings replacement rate is 30% and the PVA content is 0.3%, the mid-span and flexural strength of specimen reach their maximum values, which has increased by 22.04% and 6.57% compared to ordinary concrete, respectively. When iron ore tailings replacement rate exceeds 30%, the flexural strength and deflection will significantly decrease. Compared to the single addition of PVA fiber, the deformation ability of specimens mixed with PVA fiber and iron ore tailings is more significantly enhanced. It can be seen from the XRD pattern that the C-S-H gel and ettringite are the most abundant under the 30% iron ore tailings replacement rate, which can significantly improve the strength of material.