The maintenance of dams is crucial given their social, environmental and economic relevance. However, more than 40% of the world's dams are over 40 years old.Furthermore, due to their ageing, damage such as cracks, leaks and remaining movements have the potential to affect their serviceability and safety. This paper provides dam maintenance technicians with a methodology that first provides a diagnostic hypothesis, as maintenance work can only be considered if the source of the problem is known. The methodology provides technicians with tools for making decisions to ensure the short and long-term sustainable management of a fundamental resource for societies. The analysis uses a transversal approach broken into three stages: study of the structure's "clinical" history, field inspection and analysis. These tasks are described from a technical point of view with a range of examples and graphs to demonstrate their practical usefulness and to facilitate implementation.