This research investigates the effects of iron tailings content on the mechanical properties and durability of concrete under dry–wet cycling and negative temperature conditions (−10 °C), where iron tailings replace river sand at rates of 0%, 10%, 20%, and 30%. A variety of tests were conducted on the iron tailings concrete, including compressive strength, flexural strength, splitting tensile strength, mass loss, and relative dynamic modulus, and its pore characteristics were analyzed using low-field nuclear magnetic resonance (NMR) experiments. The results reveal that when 20% of the river sand was replaced with iron tailings, the concrete achieved optimal splitting strength, compressive strength, and flexural strength at 28 days, improving by 0.46 MPa, 3.14 MPa, and 0.41 MPa, respectively, compared to conventional concrete. Furthermore, the concrete containing this proportion of iron tailings demonstrated superior mechanical properties and durability in both negative temperature conditions and dry–wet cycling experiments. Due to the excellent physical and chemical properties of iron tailings, they enhance the performance of concrete when incorporated in appropriate quantities. The fine granularity of iron tailings helps to compensate for the granularity defects in concrete aggregates by filling internal voids, optimizing the pore structure, and improving the concrete’s density and integrity. This enhances the concrete’s mechanical properties and its resistance to external solutions and harmful ion penetration. Additionally, the active substances in iron tailings promote the hydration reaction of cement, leading to the formation of an increased amount of C-S-H gel and other hydration products in the cement system.