This study presents a comprehensive workflow for the structural design of additively manufactured concrete structures, addressing the limitations of 3D printing while leveraging its unique advantages. The proposed methodology consists of four main stages: (1) global geometry generation, (2) segmentation into manufacturable and assemblable components, (3) detailed structural design, and (4) advanced structural analysis. A multi-fidelity design approach underpins the workflow. Low-fidelity models—such as discrete strut-and-tie networks—capture principal force paths and support rapid form exploration. High-fidelity models, on the other hand, incorporate continuous geometries and detailed stress fields to enhance design precision. This interplay between abstraction and accuracy enables efficient navigation of the design space without compromising structural performance. Low-fidelity configurations are generated using Vector-based Graphic Statics and Combinatorial Equilibrium Modelling [1], facilitating fast and flexible form-finding. These configurations are then refined through high-fidelity simulations, employing finite element analysis (FEA), structural optimization, and advanced filtering and projection techniques [2] to achieve optimal performance. A key feature in the workflow is the integration of segmentation with structural optimization. Rather than treating segmentation as a post-design step, the process is driven by the objective of aligning segment boundaries with principal stress trajectories. This alignment ensures that joints are primarily subjected to normal stresses, improving structural efficiency and constructability. The segmentation strategy is informed by stress analysis under specific loading scenarios and followed by a detailed FEA of the complete structure. The workflow is demonstrated through a case study involving the design, fabrication, and assembly of a segmented, 3D-printed pedestrian bridge using the Selective Paste Intrusion technique [3]. The case study illustrates the effectiveness of the approach in optimizing structural performance from the early design stages while ensuring both global and local stability and meeting the constraints of the chosen manufacturing process.