Abstract: Prestressed Concrete Cylinder Pipe (PCCP) holds an important position in the construction of water conveyance and regulation projects and is widely used. As a composite pipe, its modes of failure are numerous and complex, and the precise types and degrees of failure depend on high-precision detection and monitoring technologies to reveal. Based on a summary of the common modes of failure, causes, and hazards of PCCP, a compilation of PCCP detection methods based on electromagnetic detection, ultrasonic detection, and radiographic detection technologies in recent years is presented, along with the proposal of new detection methods with potential for application in PCCP detection. Additionally, monitoring methods for PCCP based on distributed fiber optic technology, acoustic emission technology, and piezoelectric effects are summarized, and the application performance and further research expansion of the relevant inspection and monitoring technologies are demonstrated. On this basis, it proposes technologies for enhancing the durability of PCCP, such as material quality improvement, chloride erosion control, cathodic protection, and pipeline life prediction. It is hoped to inspire the future development direction of the PCCP industry and promote technological progress to ensure the safe and long-term operation of PCCP water conveyance and regulation projects.