<p>The monitoring of structural health in fibre-reinforced composites requires sensors that exhibit high sensitivity, flexibility, and durability to facilitate the real-time detection of strain and damage. Piezoresistive strain sensors have become a pivotal technology for the structural health monitoring (SHM) of fibre-reinforced composites (FRCs), fulfilling the increasing need for real-time, precise, and resilient sensing solutions in modern engineering structures. This review study carefully examines the ideas, materials, manufacturing techniques, and performance attributes of piezoresistive sensors, emphasising their incorporation into textile-reinforced composites. The distinctive benefits of textile-based piezoresistive sensors, such as flexibility, conformability, and compatibility with intricate geometries, are emphasised, along with their exceptional mechanical qualities and lightweight characteristics. The review elucidates the operational processes of piezoresistivity, including interface contact, quantum tunnelling, percolation networks, and crack propagation, and examines their impact on sensor sensitivity, linearity, hysteresis, and durability. Diverse methodologies for incorporating piezoresistive sensors into fibre-reinforced composites (FRCs) are analysed, including self-sensing composites, nanofiller-infused matrices, surface-mounted films, and the amalgamation of conductive yarns and filaments. The research assesses the alignment of these methodologies with industrial composite production procedures such as autoclave processing, vacuum-assisted resin transfer moulding (VARTM), and chemical vapour deposition (CVD). Essential performance metrics, such as gauge factor, stretchability, reliability, and long-term stability, are rigorously evaluated, and the obstacles of large-scale production, interfacial adhesion, signal drift, and multiaxis strain detection are examined. Recent developments in multifunctional composites, including self-healing and energy-harvesting systems, are examined, indicating the potential of intelligent, adaptive structural health monitoring platforms. The review asserts that piezoresistive textile sensors possess substantial potential for next-generation structural health monitoring in aerospace, automotive, and civil infrastructure, contingent upon the resolution of persistent challenges related to scalability, integration, and environmental stability through sustained research and innovation.</p> Graphical abstract <p></p>