The emerging electro-mechanical impedance technology has high potential for in-situ health monitoring and NDE of structural systems and complex machinery. At first, the fundamental principles of the electro-mechanical impedance method are briefly reviewed and ways for practical implementation are highlighted. The equations of piezo- electric material response are given, and the coupled electro-mechanical impedance of a piezo-electric wafer transducer as affixed to the monitored structure is discussed. Due to the high frequency operation of this NDE method, wave propagation phenomena are identified as the primary coupling method between the structural substrate and the piezo-electric wafer transducer. Attention is then focused on several recent advancements that have extended the electro-mechanical impedance method into new areas of applications and/or have developed its underlying principles. US Army Construction Engineering Research Laboratory used the electro-mechanical impedance method to monitor damage development in composite overlaid civil infrastructure specimens under full-scale static testing. A simplified E/M impedance measuring technique was employed at the Polytechnic University of Madrid, Spain, to detect damage in GFRP composite specimens. The development of miniaturized `bare-bones' impedance analyzer equipment that could be easily packaged into transponder-size dimensions is being studied at the University of South Carolina. US Army Research Laboratory developed novel piezo-composite film transducers for embedment into composite structures. Disbond gauges for monitoring the structural joints of adhesively bonded rotor blades have been studies in the Mechanical Engineering Department at the University of South Carolina. These recent developments accentuate the importance and benefits of using the electro-mechanical impedance method for on-line health monitoring and damage detection in a variety of applications. Further investigation of the electro-mechanical impedance method is warranted. A further examination of the complex interaction between wave propagation, drive-point impedance, structural damage and electro-mechanical impedance of the piezo-electric wafer transducer is needed. Once these aspects are better understood, the E/M impedance method has the potential to become a widely used NDE technique with large applicability in diverse engineering fields (aerospace, automotive, infrastructure and biomedical implants).