Structural health monitoring (SHM) has become a progressively important tool for assessing structural performance. The prestressing force is a key parameter of prestressed concrete (PSC) structures. Among various SHM methods, an impedance-based damage detection method is a promising tool for detecting local changes in PSC members. The paper aims to consolidate recent explorations and challenges in the applications of impedance-based techniques for damage detection in PSC structures. The following approaches are implemented to achieve the objective. At first, the fundamentals of piezoelectric-based impedance monitoring are briefly introduced. Then, the PZT (lead-zirconate-titanate) interface technique for impedance measurement to predetermine sensitive frequency bands is presented. Next, based on the applications of piezoelectric-based damage monitoring in PSC members, future challenges of the techniques are discussed.