Real-time monitoring of large marine structures’ health, including drilling platforms, submarine pipelines, dams, and ship hulls, is greatly needed. Among the various kinds of monitoring methods, optical fiber sensors (OFS) have gained a lot of concerns and showed several distinct advantages, such as small size, high flexibility and durability, anti-electromagnetic interference, and high transmission rate. In this paper, three types of OFS used for marine structural health monitoring (SHM), including point sensing, quasi-distributed sensing, and distributed sensing, are reviewed. Emphases are given to the applicability of each type of the sensors by analyzing the operating principles and characteristics of the OFSs. The merits and demerits of different sensing schemes are discussed, as well as the challenges and future developments in OFSs for the marine SHM field.