This paper presents recent state-of-the-art developments to obtain displacements and drift ratios for seismic monitoring and damage assessment of buildings. In most cases, decisions on safety of buildings following seismic events are based on visual inspections of the structures. Real-time instrumental measurements using GPS or double integration of accelerations, however, offer a viable alternative. Relevant parameters, such as the type of connections and structural characteristics (including storey geometry), can be estimated to compute drifts corresponding to several pre-selected threshold stages of damage. Drift ratios determined from real-time monitoring can then be compared to these thresholds in order to estimate damage conditions drift ratios. This approach is demonstrated in three steel frame buildings in San Francisco, California. Recently recorded data of strong shaking from these buildings indicate that the monitoring system can be a useful tool in rapid assessment of buildings and other structures following an earthquake. Such systems can also be used for risk monitoring, as a method to assess performance-based design and analysis procedures, for long-term assessment of structural characteristics of a building, and as a possible long-term damage detection tool.