Increased awareness of the economic and social effects of aging, deterioration and extreme events on civil infrastructure has been accompanied by recognition of the need for advanced structural health monitoring and damage detection tools. Today, these tasks are done by visual inspection and very traditional methods such as x-ray, C-scan, etc, that are expensive and sometimes ineffective for large-scale structures. In this paper we summarize the recent pioneering research work in piezoelectric-based smart aggregates structural health monitoring and their innovative applications in concrete civil structures. Piezoelectric transducers (PZT) have advantages such as low cost, simplicity for implementation, quick response, active sensing and availability in different shapes. One embedded piezoelectric patch is used as an actuator to generate high frequency waves, and the other piezoelectric patches are used as sensors to detect the propagation waves. With the existence of cracks or other faults in the structure, incoming signal from the sensor is reduced or it completely disappears in the case of failure. We have presented different signal-processing tools such as Wavelet analysis, Fast Fourier Transform, Hilbert-Huang transform. Furthermore, current software and numerical research in this area are presented, using finite element method and software programs such as ABAQUS and ANSYS.