This paper presents practical methods and techniques for rehabilitation and strengthening marine terminal piers in the USA. These piers are waterfront structures for berthing of large cargo vessels and cruise vessels. Typically, the piers consist of timber or concrete deck supported on multiple pile bents. The piers are subjected to large impact forces from the mooring of the vessels acting at the fenders and bollards, in addition to the other normal vertical dead and live loads. Depending on the size of the vessels, the design service loads on the bollards are in the range of 100 tons to 200 tons. Other possible severe loads are from the winds and waves during the hurricanes. The piers are continuously exposed to outdoor, marine and coastal environments, which are corrosive in nature. For these reasons, all piers of 15 years or more are normally up for repair/rehabilitation. Typical deteriorations found are: cracked and spalled concrete, rust in exposed reinforcing bars, broken timber piles, timber piles with reduced cross sections, cracked concrete piles, corroded steel piles, and displaced out-of-plumb piles. The paper presents the methods for repairing the above-mentioned defects. For concrete crack and spall repair: sealing with epoxy, concrete patching and shotcrete are used. For pile repair: concrete jacketing of piles is used for splicing or strengthening of piles.