Prestressed concrete floating structures have been used for over a century with notable success in various parts of the world. However, there still exist issues related to the analysis and design, and the service performance of concrete floating structures. This paper highlights the design concepts, material behavior, analysis approaches and structural systems for floating prestressed concrete structures deployed in shallow waters. Material and design requirements related to prestressed concrete floating structures in particular are reviewed and potential technical challenges are identified. Moreover, some recommendations and suggestions are summarized as a guide for future practice.