Piezoelectric wafer active sensors (PWAS) are lightweight and inexpensive transducers that enable a large class of structural health monitoring (SHM) applications such as: (a) embedded guided wave ultrasonics, i.e., pitch-catch, pulse-echo, phased arrays; (b) high-frequency modal sensing, i.e., electro-mechanical impedance method; and (c) passive detection. The focus of this paper is on the challenges posed by using PWAS transducers in the composite laminate structures as different from the metallic structures on which this methodology was initially developed. After a brief introduction, the paper reviews the PWAS-based SHM principles. It follows with a discussion of guided wave propagation in composites and PWAS tuning effects. Then, the mechanical effect is discussed on the integration of piezoelectric wafer inside the laminate using a compression after impact. Experiments were performed on a glass fiber laminate, employing PWAS to measure the attenuation coefficient. Finally, the paper presents some experimental and multi-physics finite element method (MP-FEM) results on guided wave propagation in composite laminate specimens.