The number, height, and scale of existing concrete dams in China rank high in the world. Long-term service of dam engineering has a significant influence on dam safety as well as economic construction, social stability, and ecological safety. Based on an analysis of the current status of concrete dam construction and safety in China, the current status of long-term service of concrete dams and theories, methods, and techniques for the risk assessment of concrete dams are summarized from the aspects of concrete material performance evolution, concrete dam disease monitoring, construction quality control, and risk management and assessment. The law of concrete material performance evolution under the coupling effect of multiple factors, the intelligent monitoring of hidden dangers and diseases of concrete dams as well as dam construction quality, the standards and practical methods for dam risk assessment, and the probability calculation and consequence evaluation of dam breaks should be emphasized in future studies, so as to ensure dam safety during long-term service and improve the theories and methods of concrete dam risk assessment.