The phenomenon of hydraulic structure concrete abrasion, caused by the water-carried sediment abrasion process, is analyzed in this paper. There was detailed investigation of laboratory procedure adequacy for definition of concrete abrasion level in standard ASTM C1138 hydraulic structures. Assessment was based on comparison of laboratory results and natural condition measurements of concrete abrasion resistance by test plot performance in the Vrhovo hydro power plant (HPP) stilling basin. There was adequacy testing of the concrete built in the HPP's evacuation structures on the Lower Sava River. There was modification of basic concrete composition by pozzolanic or polymer additives, along with granular rubber, polypropylene fibers, steel fibers, and the primary binder. A qualitative similarity was shown in the analysis on concrete abrasion level between field measurements and laboratory simulations, as well as ASTM C1138 laboratory method suitability for concrete abrasion resistance assessment in the spillway of the lower Sava River's HPP chain. Quantitative results comparison showed a good correlation between natural environment measurements and laboratory measurements for concrete at 900 days, while this correlation was not confirmed for the concrete at 90 days.