The recent advent of highly durable engineering materials and the advancement of latest structural design theories have made possible the fabrication of more efficient engineering structures. However, the safety and reliability of these structures remains the primary challenge and concern for engineers. Especially, for those structures which involve human traffic and huge investments such as the aerospace structures and bridges. Therefore, there is a compelling need to have high-quality online structural health monitoring (SHM) of such structures. The development of a real-time, in-service, and smart material-based SHM method has recently attracted the interest of a large number of academic and industrial researchers. In the recent past, piezoceramic (PZT) transducer has evolved as an efficient smart material, which is usually employed in electro mechanical impedance (EMI) and guided ultrasonic wave propagation techniques. In EMI technique, a PZT transducer interact with the host structure to result in unique health signature, as an inverse function of structural impedance, when it is subjected to high-frequency structural excitations in the presence of electric field. Using the self-actuating and sensing capabilities of PZT transducers, the EMI models attempted to detect loadings on, and damages in, the structures to be monitored. This article reviews some of the advancements in the field of PZT-based SHM made over the past two decades in engineering structures. This article also provides an insight into the possible future work and improvements required for PZT-based EMI technique.