Structural health monitoring (SHM) systems are used to analyze the health of infrastructures such as bridges, using data from various types of sensors. While SHM systems consist of various stages, feature extraction and pattern recognition steps are the most important. Consequently, signal processing techniques in the feature extraction stage and machine learning algorithms in the pattern recognition stage play an effective role in analyzing the health of bridges. In other words, there exists a plethora of signal processing techniques and machine learning algorithms, and the selection of the appropriate technique/algorithm is guided by the limitations of each technique/algorithm. The selection also depends on the requirements of SHM in terms of damage identification level and operating conditions. This has provided the motivation to conduct a Systematic literature review (SLR) of feature extraction techniques and pattern recognition algorithms for the structural health monitoring of bridges. The existing literature reviews describe the current trends in the field with different focus aspects. However, a systematic literature review that presents an in-depth comparative study of different applications of machine learning algorithms in the field of SHM of bridges does not exist. Furthermore, there is a lack of analytical studies that investigate the SHM systems in terms of several design considerations including feature extraction techniques, analytical approaches (classification/ regression), operational functionality levels (diagnosis/prognosis) and system implementation techniques (data-driven/model-based). Consequently, this paper identifies 45 recent research practices (during 2016–2023), pertaining to feature extraction techniques and pattern recognition algorithms in SHM for bridges through an SLR process. First, the identified research studies are classified into three different categories: supervised learning algorithms, neural networks and a combination of both. Subsequently, an in-depth analysis of various machine learning algorithms is performed in each category. Moreover, the analysis of selected research studies (total = 45) in terms of feature extraction techniques is made, and 25 different techniques are identified. Furthermore, this article also explores other design considerations like analytical approaches in the pattern recognition process, operational functionality and system implementation. It is expected that the outcomes of this research may facilitate the researchers and practitioners of the domain during the selection of appropriate feature extraction techniques, machine learning algorithms and other design considerations according to the SHM system requirements.