To investigate the capability of piezoelectric lead zirconate titanate (PZT) sensors in monitoring the confinement effect of confined concrete short columns, this study first performed numerical simulations to analyze the relationship between internal concrete stress and the conductance signals of embedded PZT sensors under axial compression loading. Subsequently, four concrete short columns with different external confinement forms were designed and fabricated. By comparatively analyzing the conductance responses of PZT sensors embedded at two orientations (0° and 90°), it was determined that both sensor orientations could effectively monitor the initiation of confinement action in concrete columns. The conductance signal from the 90°-oriented sensor exhibited a monotonic trend during the elastic stage but reversed noticeably upon entering the plastic stage. In contrast, the 0°-oriented sensor showed a relatively slow variation during the elastic stage, followed by a significant deviation once entering the plastic stage, demonstrating higher sensitivity and making it more suitable for evaluation of confinement effects. Finally, the root mean square deviation (RMSD) of the conductance signals was computed to quantitatively assess the effectiveness of different confinement forms. Additionally, embedded stress sensor measurements showed consistent trends with the PZT sensor signals, further validating the accuracy of using PZT sensors for assessing the confinement effect in confined concrete short columns.