Railway transport of goods and passengers is effective in terms of energy conservation and travel time savings. Safety and ride quality have become important issues as train speeds have increased. Due to increased speeds, minor damage to railway structures and abnormal interactions between trains and structures have given rise to increasingly serious accidents. Therefore, structural health and operational conditions must be monitored continuously in all service environments. Currently, various health and operation management systems are being developed and these are reducing both maintenance frequency and costs associated with disassembly. In this review, major damage and malfunctions and their locations are first analyzed based on numerous references. Then advanced train health and operation management technologies are classified into wayside detection methods and advanced integrated sensor methods and their operating principle and functions are reviewed and analyzed.