Structurally integrated sensors which are capable of continuous structural health monitoring represent an attractive option in view of their potential for providing real-time assessment/warning of structural damage. In recent years, optical fiber systems have attracted a considerable amount of attention and have been shown to be a very attractive option for health monitoring in advanced composite materials. These sensors have either been embedded or surface-bonded to the host material thereby allowing continuous assessment of the health of the structure. Structural health assessment takes the form of damage detection and/or monitoring of specific health indicators. In the former approach, the optical fiber systems are generally optimized to increase their sensitivity to the presence of damage in the composite structure, while the latter approach relies on the examination of characteristic changes in the monitored parameter to infer a loss in structural integrity. To this end, many investigators have demonstrated the potential of optical fiber sensors, most particularly intensity-based optical fiber systems and fiber Bragg grating sensors for structural health monitoring of advanced composite materials. The initial part of this paper provides an up-to-date review of the applications of optical fiber sensors in composite materials, focussing particularly on the use of intensity-based optical fiber systems and fiber Bragg grating sensors for damage detection. These optical fiber systems have been shown to be capable of detecting impact damage, transverse cracking, and delamination, and have the ability to monitor strain in structures. The introduction of optical fiber sensors into a composite material can inadvertently produce a geometrical discontinuity in the vicinity of the sensor. Numerous experimental investigations have also been performed to assess the possible reduction in the properties of the host structure. A review of the findings of these investigations reported in the literature is also given. This review article cites 161 references.