Material damage in structures must be detected in a timely manner to prevent engineering accidents. Damage detection based on structural flexibility has attracted widespread attention in recent years due to its simplicity and practicality. This article provides a detailed overview of damage detection methods based on structural flexibility. Depending on the calculation method and data used, flexibility-based methods can be divided into the following categories: flexibility difference, flexibility derivative index, flexibility sensitivity, flexibility decomposition, static flexibility, and combinations of flexibility with other methods. The basic principles and main calculation formulas of various flexibility methods are explained, and their advantages and disadvantages are analyzed. For the method using flexibility difference, the advantage is that the calculation is very simple and does not require the construction of a finite element model of the structure. The disadvantage is that it requires the measurement of modal data of the intact structure, and this method cannot quantitatively assess the degree of damage. For the method using the flexibility derivative index, the advantage is that it only requires the modal data of the damaged structure to locate the damage, but this method is particularly sensitive to noise in the data and is prone to misjudgment. For methods based on flexibility sensitivity and flexibility decomposition, the advantage is that they can simultaneously obtain the location and degree of damage in the structure, but the disadvantage is that they require the establishment of accurate finite element models in advance. Static flexibility methods can compensate for the shortcomings of dynamic flexibility methods, but they usually affect the normal use of the structure during static testing. Combining flexibility-based methods with advanced intelligent algorithms and other methods can further improve their accuracy and efficiency in identifying structural damage. Finally, this article discusses the challenges that have not yet been solved among damage detection methods based on structural flexibility.