Structural health monitoring of RC structures under seismic loads has recently attracted attention in the earthquake engineering research. In this paper, a piezoceramic-based device called “smart aggregate” was used for the health monitoring of RC frame structures under earthquake excitations. A two-story one-bay RC moment frame instrumented with smart aggregates was tested using a shake table. The distributed piezoceramic-based smart aggregates embedded in the RC structures were used to monitor the health condition of the structures during the tests. The sensitiveness and effectiveness of the proposed piezoceramic-based approach were investigated and evaluated by analyzing the measured responses.