There is a growing trend in applying a prognostics and health management approach to engineering systems in general and space and aviation systems in particular. This paper reviews the role of prognostics and health management approach in support of integrated risk-based applications to nuclear power plants, like risk-based in-service inspection, technical specification optimization, maintenance optimization, etc. The review involves a survey of the state-of-art technologies in prognostics and health management and an exploration of its role in support of integrated risk-based engineering and how the technology can be adopted to realize enhanced safety and operational performance. An integrated risk-based engineering framework for nuclear power plants has been proposed, where probabilistic risk assessment plays the role of identification, prioritization and optimization of systems, structures, and components, while deterministic assessment is performed using a prognostics and health management approach. Keeping in view the requirements of structural reliability assessment, the paper also proposes essential features of a ‘Mechanics-of-Failure’ approach in support of integrated risk-based engineering. The performance criteria used in prognostics and health management has been adopted to meet requirements of risk-based applications.