In this chapter, results concerning the influence of the concrete composition on the compressive fatigue behaviour are presented and a mesoscopic modelling approach for fatigue damage is developed to capture these influences within numerical simulations. The influences of coarse aggregates generally, the substitution of basalt by granite coarse aggregate, the addition of silica fume and the variation of the water to cement (w/c) ratio were investigated systematically. The results show that the presence of coarse aggregates can influence the fatigue behaviour of concretes in a negative way at higher stress levels and in a positive way at lower stress levels compared to mortars. Silica fume improves the fatigue behaviour of concrete and mortar strongly. An increase of the w/c ratio and, thus, an increase in the porosity reduces the fatigue resistance of concrete and mortar significantly. The acoustic emission technique used additionally gives further valuable strain-independent information about the damage processes occurring on different scales. A modelling approach and simulations of compressive fatigue damage are additionally presented. They are based on a gradient-enhanced damage formulation with a reduction of the material strength dependent on the strain history.