Nowadays, hydropower plants are being used to compensate for the variable power produced by the new fluctuating renewable energy sources, such as wind and solar power, and to stabilise the grid. Consequently, hydraulic turbines are forced to work more often in off-design conditions, far from their best efficiency point. This new operation strategy increases the probability of erosive cavitation and of hydraulic instabilities and pressure fluctuations that increase the risk of fatigue damage and reduce the life expectancy of the units. To monitor erosive cavitation and fatigue damage, acoustic emissions induced by very-high-frequency elastic waves within the solid have been traditionally used. Therefore, acoustic emissions are becoming an important tool for hydraulic turbine failure detection and troubleshooting. In particular, artificial intelligence is a promising signal analysis research hotspot, and it has a great potential in the condition monitoring of hydraulic turbines using acoustic emissions as a key factor in the digitalisation process. In this paper, a brief introduction of acoustic emissions and a description of their main applications are presented. Then, the research works carried out for cavitation and fracture detection using acoustic emissions are summarised, and the different levels of development are compared and discussed. Finally, the role of artificial intelligence is reviewed, and expected directions for future works are suggested.