Abstract: Objectives The ship structural health monitorin system serves as a critical technology for ensuring vessel operational/t/nsafety. The deep integration of large-scale models with structural health monitoringcan significantly enhance monitoring efficiency and accuracy. This paper systematically reviews the state-of-the-art of key technologies in this field, analyzes existing technical challenges, and proposes future development directions to facilitate advancements in structural health monitoring systems.Methods This study systematically reviews research progress in marine sensor technology for typical scenarios, virtual-physical fusion-based measurement point layout planning technology, data denoising and compensation technology, as well as ship stress reconstruction and load inversion technology. By leveraging the advantages of large models in feature extraction, multimodal fusion analysis, and autonomous learning, it proposes targeted future development directions for ship structural health monitoring systems. Results Current research shows that while the four key technologies of ship structural health monitoring systems have made progress, they still face numerous challenges. The monitoring stability and applicability of marine sensor networks need improvement; existing measurement point layout schemes demonstrate insufficient capability for multiphysics collaborative monitoring and lack effective optimization algorithms; data denoising and compensation technologies have limitations in real-time computational efficiency and accuracy; and the reliability of stress distribution reconstruction and load inversion technologies under long-term real complex sea conditions requires further verification. Conclusions Future development should prioritize three key technical breakthroughs: intelligent self-diagnostic systems and optimized measurement point layouts for marine sensors, large model-driven real-time multimodal data processing and multi-ship-type technology transfer, and physics-informed intelligent inversion coupled with digital twin platform development. These advancements will provide enhanced structural safety assurance throughout a vessel's entire lifecycle.