Due to the long-term service, Chinese ancient timber buildings show varying degrees of wear. Thus, structural health monitoring (SHM) for these cultural and historical treasures is desperately needed to evaluate the service status. Although there are some FBG sensing-based SHM systems, they are not suitable for Chinese ancient timber buildings due to the differences in architectural types, structural loads, materials, and environment. Besides, a technical gap in Fiber Bragg grating (FBG) sensing-based column inclination monitoring exists. To overcome these weaknesses, this paper develops an FBG sensing-based structural health monitoring system for Chinese ancient Chuan-dou-type timber buildings that aims at monitoring structural deformation, i.e., beam deflection and column inclination, temperature, humidity, and fire around the building. An in-situ test and simulation analyses were conducted to verify the effectiveness of the developed SHM system. To validate the long-term-operation of the developed SHM system, monitoring data within 15 months were analyzed. The results show good agreement between the developed SHM system in this paper and other methods. In addition, the SHM system operated well in the first year after its deployment. This implies that the developed SHM system is applicable and effective in the health state monitoring of Chinese ancient Chuan-dou-type timber buildings, laying a foundation for damage prognosis of such types of timber buildings.