Rail tracks undergo massive stresses that can affect their structural integrity and produce rail breakage. The last phenomenon represents a serious concern for railway management authorities, since it may cause derailments and, consequently, losses of rolling stock material and lives. Therefore, the activities of track maintenance and inspection are of paramount importance. In recent years, the use of various technologies for monitoring rails and the detection of their defects has been investigated; however, despite the important progresses in this field, substantial research efforts are still required to achieve higher scanning speeds and improve the reliability of diagnostic procedures. It is expected that, in the near future, an important role in track maintenance and inspection will be played by the ultrasonic guided wave technology. In this manuscript, its use in rail track monitoring is investigated in detail; moreover, both of the main strategies investigated in the technical literature are taken into consideration. The first strategy consists of the installation of the monitoring instrumentation on board a moving test vehicle that scans the track below while running. The second strategy, instead, is based on distributing the instrumentation throughout the entire rail network, so that continuous monitoring in quasi-real-time can be obtained. In our analysis of the proposed solutions, the prototypes and the employed methods are described.