This work aims to explore efficient and accurate structural design methods for orthotropic plates. The design challenges are addressed by introducing a novel Continuum Sensitivity Analysis (CSA) technique capable of managing multiple design variables and constraints. CSA has demonstrated superior accuracy and efficiency compared to traditional numerical sensitivity analysis methods, particularly in shaping high-performance air vehicles, even with numerous design variables. This study extends CSA to orthotropic plates for the first time and establishes an efficient simulation framework for high-fidelity structural shape optimization. The CSA approach facilitates the calculation of shape derivatives with respect to multiple design variables at a minimal computational time. Furthermore, this method is non-intrusive and compatible with black-box programs like NASTRAN, providing more accurate high-fidelity sensitivities than those currently available from the software.