Abstract: The ship structural health monitoring system is critical for ensuring vessel operational safety. The deep integration of large-scale models with structural health monitoring can significantly improve monitoring efficiency and accuracy. This paper provides a systematical review of the state-of-the-art of key technologies in this field, analyzes existing technical challenges, and proposes future development directions to advance structural health monitoring systems. Specifically, the study reviews research progress in marine sensor technologies for typical scenarios, virtual-physical fusion-based measurement point layout planning, data denoising and compensation techniques, as well as ship stress reconstruction and load inversion methods. By leveraging the advantages of large models in feature extraction, multimodal fusion analysis, and autonomous learning, this study proposes targeted future development directions for ship structural health monitoring systems. Current research indicates that, although the four key ship structural health monitoring technologies have advanced, they still face significant challenges. The stability and applicability of marine sensor networks require improvement, existing measurement point layout schemes are insufficient for multiphysics collaborative monitoring and lack effective optimization algorithms, data denoising and compensation techniques are limited in real-time computational efficiency and accuracy, and the reliability of stress distribution reconstruction and load inversion methods under long-term, real-world complex sea conditions requires further validation. Future development should focus on three major 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 enhance structural safety assurance throughout a vessel's entire lifecycle.