In this paper, municipal sewage treatment plant sludge and Dexing copper mine tailings were used as the main raw materials to prepare ceramsite by high temperature sintering. The ratio of raw materials and sintering process parameters were determined by experiments. The physical properties (bulk density, apparent density, 1 h water absorption rate, void ratio) of ceramsite, heavy metal content in leaching solution, and the adsorption of lead ions by ceramsite were analyzed. The ceramsite was used to replace the gravel in ordinary concrete to varying degrees (0%, 20%, 40%, 60%, 80%, 100%, mass fraction), and the changes of cube compressive strength and splitting tensile strength of concrete were studied. The results show that the raw materials are mixed and granulated according to m(sludge)∶m(tailings)∶m(clay)=2∶3∶1, and the sintering process is drying at (105±5) ℃ for 3 h, preheating at 400 ℃ for 15 min, and sintering at 1 000 ℃ for 12 min. Then the bulk density of the prepared ceramsite is 528 kg/m3, the apparent density is 1 004 kg/m3, the 1 h water absorption rate is 7.64%, and the void ratio is 47.37%. The content of heavy metals in ceramsite leaching solution is lower than the limit of national standard. The adsorption rate of lead ions by ceramsite sintered at 960 ℃ reaches 93.57% under the condition of 30 ℃ constant temperature water bath. After adding ceramsite, with the increase of ceramsite replacement rate, the cubic compressive strength and splitting tensile strength of ceramsite concrete increase first and then decrease. When the ceramsite replacement rate is 60%, the compressive strength of the cubic test block cured for 28 d reaches the maximum of 35.38 MPa. When the ceramsite replacement rate is 40%, the splitting tensile strength reaches the maximum of 5.8 MPa.