In order to ensure the safety and preserve the value of historical buildings, inclination is an essential parameter during the continuous structural health monitoring process. However, the wire and price of a traditional sensor limit application. This paper proposes a low-cost inclination sensor based on a patch antenna with a reconfigurable water load. Only the water directly on the antenna is considered effective. The different volume of the effective water load, which is determined by the inclination of the attached surface, will affect the effective permittivity of the dielectric plate of the patch antenna, further causing a variation in the resonant frequency. Therefore, the proposed antenna sensor can monitor the inclination of the attached surface by interrogating the resonant frequency. The working mechanism is first clarified by theoretically investigating the relationship between the dielectric properties and the inclination of the covering medium. The antenna sensor is then simulated using High-Frequency Structure Simulator ver.15 (HFSS 15), which helps to determine geometric parameters and confirm accuracy and sensitivity. An experiment has been conducted based on the design verified in the simulation. The inclination detection shows a correlation coefficient of 0.9771 with a sensitivity of 7.92 MHz/°, indicating a potential for real application.