Compatibility, a critical issue between sensing material and host structure, significantly influences the detecting performance (e.g., sensitive, signal-to-noise ratio) of the embedded sensor. To address this issue in concrete-based infrastructural health monitoring, cement-based piezoelectric composites (piezoelectric ceramic particles as a function phase and cementitious materials as a matrix) have attracted continuous attention in the past two decades, dramatically exhibiting superior durability, sensitivity, and compatibility. This review paper performs a synthetical overview of recent advances in theoretical analysis, characterization and simulation, materials selection, the fabrication process, and application of the cement-based piezoelectric composites. The critical issues of each part are also presented. The influencing factors of the materials and fabrication process on the final performance of composites are further discussed. Meanwhile, the application of the composite as a sensing element for various monitoring techniques is summarized. Further study on the experiment and simulation, materials, fabrication technique, and application are also pointed out purposefully.