Abstract: Engineering structures face slow ageing and gradual deterioration during their service lives, which initiates at the material level. Perceiving the deterioration in material performance at an early stage can provide help for effective maintenance before the serious structural failure, thus improving the safety and resilience as well as lifespan of the structure. Therefore, self-sensing material performance is an important paradigm for updating structure models with smart digital insights. Concrete, the most widely used engineering material, is mainly used in structures and has no intrinsic self-sensing property. The incorporation of conductive or semiconductive fillers can make concrete have the ability to sense stress, strain and damage (including crack and fatigue, etc.) in itself, and also improve its mechanical properties and durability. The emergence of intrinsic self-sensing concrete has laid a material foundation for the development of smart structures and the realization of in-situ monitoring by using the smart structure. It will systematically review the research progress of the composition and preparation, measurement and characterization, performance and regulation, mechanism and model of intrinsic self-sensing concrete, and its smart structures, as well as current challenges and strategies for future development.