Over the last two decades, the tidal energy industry has laid the groundwork for creating commercially viable tidal power generation projects to strengthen sustainable energy policies around the world. At the end of 2021, the cumulative installation of tidal stream technology that has been deployed in Europe reached 30.2 MW, where the majority of the installations are by small and medium-sized companies. Due to a growing demand among investors related to the global tidal energy industry, the reliability and safety of operational-stage tidal energy systems’ components are becoming increasingly important. In this context, companies, universities and research institutes are focusing on conducting large- and small-scale tests of tidal turbine elements to validate their projected design life, and major attention is being given to assessing the structural integrity of turbine blades. This review paper focuses on structural tests that have been reported for axial flow tidal turbine blades manufactured using composite materials around the world, highlighting the testing standards, equipment and instrumentation required. Overall, this review article discusses the state of the art in the structural testing of tidal turbine blades. In addition, it highlights the global concerns and research gaps to ensure the long-term sustainability of axial flow tidal turbine blades. In addition, the information contained in this article will be useful for formulating a smooth and reliable mechanism to enhance the evaluation process of the structural properties of tidal turbine blades in the future.