In this study, 10–50% of porcelain tile polishing residue (PPR) was used as an additive or as partial replacement of cement in concrete. The cement consumption was kept constant by correcting the amount of sand for each mixture. Concrete workability (slump) was reduced by up to 88.72% when PPR replaced the cement by up to 30%, while it was reduced by only 4.10% when PPR was added to the concrete at the same levels. Compressive strength at 28 days increased up to 92.22% with 50% PPR as additive, reducing the equivalent emission of CO2 per m³ of concrete up to 38.18%. PPR incorporation reduced the water permeability of concrete by up to 30.70% and 17.54% when used in addition and in cement replacement, respectively. Overall, PPR as an additive up to 50% and in cement with substitution levels up to 10–40% presented themselves as viable solutions for developing more resistant and durable concretes than the reference mixture (without incorporation of PPR).