Reliability, safety, and economic feasibility of future space transportation systems rely not only on their technical and operational improvements but also as a key task on implementation of health monitoring systems with innovative sensor and diagnosis technologies. The application of such systems provides the possibility to reduce signi cantly the maintenance costs and turnaround time for future reusable launch vehicles. Current development tasks and activities are described in the eld of integrated health monitoring/management for reusable launch vehicles, in particular, for large reusable cryogenic tank structures. Integrated health monitoring refers both to in-ight monitoring and on-ground veri cation phases. The dedicated engineering tasks are addressed including identi cation of critical components and conditions, selection of measurable parameters, detailed tradeoff and definition of candidate sensors, their adequate accommodation, diagnostic expert systems, and data analysis. Special emphasis is given to innovative onboard sensors such as ber optic sensors and acoustic emission sensors as well as nondestructive inspection techniques such as infrared thermography and laser shearography as the most promising methods for inspection of cryogenic tank structures subsystems and components. Finally, the importance of applying telerobotic inspections in restricted tank areas is highlighted.