Due to the harsh working conditions, the durability of the seaport wharf structure is poor compared with similar hydraulic structures. According to the structural characteristics of coastal port wharf and the particularity of a high salt and high humidity environment, the stress features of the coastal wharf structure are analyzed, and the health inspection indicators of the wharf structure are proposed. A fiber grating sensor-based structural health monitoring system for coastal high-pile piers is established. A corresponding system for detecting structural health is designed according to the standard structural section of the wharf’s front platform. The corresponding monitoring implementation scheme, sensor selection, and performance parameters are proposed. Finally, the realization technology and related indicators of data acquisition and transmission subsystem are given. The experimental results indicate that the waveform of the structural response to the wave load has a consistent sine wave pattern with the actual wave load. The maximum strain of the berthing pier appears at 4.35 m and 6.14 m, and the elevations reach 4.66 με and 5.31 με, respectively. The strain at other positions also has an obvious change trend. The experimental results provide some help for the research of the wharf health monitoring system.