The successful implementation of Structural Health Monitoring (SHM) systems is confined to the capability of evaluating their performance, reliability, and durability. Although there are many SHM techniques capable of detecting, locating and quantifying damage in several types of structures, their certification process is still limited. Despite the effort of academia and industry in defining methodologies for the performance assessment of such systems in recent years, many challenges remain to be solved. Methodologies used in Non-Destructive Evaluation (NDE) have been taken as a starting point to develop the required metrics for SHM, such as Probability of Detection (POD) curves. However, the transposition of such methodologies to SHM is anything but straightforward because additional factors should be considered. The time dependency of the data, the larger amount of variability sources and the complexity of the structures to be monitored exacerbate/aggravate the existing challenges, suggesting that much work has still to be done in SHM. The article focuses on the current challenges and barriers preventing the development of proper reliability metrics for SHM, analyzing the main differences with respect to POD methodologies for NDE. It was found that the development of POD curves for SHM systems requires a higher level of statistical expertise and their use in the literature is still limited to few studies. Finally, the discussion extends beyond POD curves towards new metrics such as Probability of Localization (POL) and Probability of Sizing (POS) curves, reflecting the diagnosis paradigm of SHM.