The growing concern about the protection of built heritage and the sustainability of urban areas has driven the reoccupation of existing masonry buildings, which, in the great majority of the cases, were not designed or constructed to withstand significant seismic forces. This fact, associated with territorial occupation often concentrated in areas with high seismic hazard, makes it essential to look at these buildings from the point of view of the assessment of their seismic vulnerability and retrofitting needs. However, to be effective and efficient, such an assessment must be founded on a solid knowledge of the existing methods and tools, as well as on the criteria that should underlie the selection of the most appropriate to use in each context and situation. Aimed at contributing to systematise that knowledge, this paper presents a comprehensive review of the most relevant vulnerability assessment methods applicable at different scales, as well as the most significant traditional and innovative seismic retrofitting solutions for existing masonry buildings.