This study investigated the design and performance of piezoelectric nanocomposite-based interdigitated transducers (IDTs) for active sensing and damage detection. First, thin films that are highly piezoelectric and mechanically flexible were designed by embedding zinc oxide (ZnO) nanoparticles in a poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) piezo-polymer matrix. Second, the suspended nanoparticle solutions were then spin coated onto patterned comb electrodes to fabricate the IDTs. The films were then poled to align their electric domains and to increase their permanent piezoelectricity. Upon IDT fabrication, its sensing and actuation of Lamb waves on an aluminum pipe was validated. These results were also compared to data obtained from commercial Macro Fiber Composite IDT transducers. In the last phase of this work, damage detection was demonstrated by mounting these nanocomposite sensors and actuators (using a pitch-catch setup) onto an aluminum pipe and plate. Damage was simulated by tightening a band clamp around the pipe and by drilling holes in the plate. A damage index calculation was used to compare results corresponding to different levels of damage applied to the plate (i.e., different drilled hole depths), and good correlation was observed. Thus, ZnO/PVDF-TrFE transducers were shown to have the potential for use as piezoelectric transducers for structural health monitoring and damage detection.