Inland navigation structures (INS) facilitate transportation of goods in rivers and canals. Transportation of goods over waterways is more energy efficient than on roads and railways. INS, similar to other civil structures, are aging and require frequent condition assessment and maintenance. Countries, in which INS are important to their economies, such as the Netherlands and the United States, allocate significant budgets for maintenance and renovation of exiting INS, as well as for building new structures. Timely maintenance and early detection of a change to material or geometric properties (i.e., damage) can be supported with the structural health monitoring (SHM), in which monitored data, such as load, structural response, environmental actions, are analyzed. Huge scientific efforts are realized in bridge SHM, but when it comes to SHM of INS, the efforts are significantly lower. Therefore, the SHM community has opportunities to develop new solutions for SHM of INS and convince asset owners of their benefits. This review article, first, articulates the need to keep INS safe to use and fit for purpose, and the challenges associated with it. Second, it defines and reviews sensors, sensing technologies, and approaches for SHM of INS. Then, INS and their components, including structures in ports, are identified, described, and illustrated, and their monitoring efforts are reviewed. Finally, the review article emphasizes the added value of SHM systems for INS, concludes on the current achievements, and proposes future trajectories for SHM of INS and ports.