A review of recent research on structural monitoring in railway industry is proposed in this paper, with a special focus on stress-based solutions. After a brief analysis of the mechanical behaviour of ballasted railway tracks, an overview of the most common monitoring techniques is presented. A special attention is paid on strain gages and accelerometers for which the accurate mounting position on the track is requisite. These types of solution are then compared to another modern approach based on the use of optical fibres. Besides, an in-depth discussion is made on the evolution of numerical models that investigate the interaction between railway vehicles and tracks. These models are used to validate experimental devices and to predict the best location(s) of the sensors. It is hoped that this review article will stimulate further research activities in this continuously expanding field.