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In multi-storey buildings, columns are usually not continuous through the slabs to enhance ease of construction. Consequently, in slab–column joints, slabs have to carry column loads in addition to the shear and bending moments due to loads applied to the slab. In most cases, when high strength concrete is used for the columns and normal strength concrete for the slabs, compression stresses at the support areas of the inner columns exceed the uniaxial compressive strength of the concrete of the slab. Due to this reason, most current details for such regions reinforce the concrete of the slab between columns to ensure load transfer. Typically, this is achieved by linking top and bottom columns with reinforcement. Sometimes, it is also needed to incorporate special load transfer devices. This latter solution is however relatively complicated and expensive. In this paper, the crushing and flexural strength of slab–column joints is investigated accounting for an increase of the compressive strength of the failure region (concrete between columns) due to confinement stresses provided by the flexural reinforcement of the slab. The results of an experimental programme on 6 full-scale slabs (250 mm thick) are presented showing that flexural reinforcement of a slab significantly increases the crushing strength of slab–column joints. This allows ensuring load transfer without incorporating special devices or even without linking top and bottom column reinforcement for a wide range of cases leading potentially to more economic designs. An analytical approach, grounded on the theory of plasticity, is also presented allowing one to determine a failure criterion for such regions. This approach, which can also be used for design purposes, leads to an excellent correlation with test results.