Abstract: To investigate the sensitivity of ultrasonic waves in various vibration modes due to stress changes in concrete structures, this study derives theoretical expressions for acoustoelastic coefficients based on bulk wave and surface wave acoustoelastic equations. The influence of stress changes in concrete structures on ultrasonic waves in different vibration modes is quantitatively analyzed. The theoretical findings are validated through a uniaxial quasi-static compression test on concrete, and the test values of acoustoelastic coefficients for different waveforms are obtained by utilizing the cross-correlation algorithm. The results indicate that the longitudinal wave propagating parallel to the stress direction (LW11) exhibits the highest sensitivity to stress changes in concrete structures. The Rayleigh wave propagating parallel to the stress direction (RW1) demonstrates the second-highest sensitivity, followed by the transverse wave propagating parallel to the stress direction (TW12). Longitudinal wave (LW22) and transverse wave (TW2) that propagate perpendicular to the stress direction exhibit relatively low stress sensitivity. Based on experimental and theoretical findings and, considering the feasibility of engineering applications, the Rayleigh wave is recommended as the optimal waveform for the ultrasonic detection of concrete stress states. These research results hold promising reference value for the investigation and application of ultrasonic detection technology in assessing the stress state of concrete structures.