NASA has been under scrutiny to find a solution to reducing the costs associated with space launches. To reduce operations cost, future launch vehicles like the Reusable Launch Vehicle (RLV) must include the following elements: highly reliable, robust subsystems designed for simple repair access with simplified servicing infrastructure and incorporating expedited decision making about faults and anomalies. A key component for the Single Stage to Orbit (SSTO) X-33/RLV System used to meet these objectives is System Health Management(SHM). SHM deals with the vehicle component-Vehicle Health Management, the ground processing associated with the vehicle fleet (GVHM) and the Ground Infrastructure Health Management(GIHM). The objective is to provide an automated collection and paperless health decision, maintenance and logistics system. Many critical technologies are necessary to make the SHM (and more specifically VHM) practical, reliable and cost effective. Sanders is leading the integration of the SHM system for RLV and for X-33. (X-33 is a sub-scale, sub-orbit technology demonstrator.) The reusable tanks are a key system for both X-33 and RLV. These tanks are being designed by LMMSS. LMMSS has been working with NASA Langley to develop distributed optical systems for tank health monitoring. These will be demonstrated on X-33. This paper presents the RLV SHM baseline; the X-33 SHM, VHM and GVHM architecture; the X-33 tank VHM subsystem and testing; and the distributed optical sensor technology and design. The paper also discusses other applications of these technologies.