The condition assessment of concrete sleepers poses a challenge for the South African rail network for two primary reasons: the scale at which measurements need to be conducted and the presence of ballast stone, which obstructs direct access to the sleepers for visual and non-destructive assessment. Literature related to common concrete sleeper defects and methods of condition assessment was reviewed. Literature was used to assess which of the concrete sleeper functional requirements a specific defect will inhibit or prohibit. A Failure Mode and Effect Analysis (FMEA) showed the severity of the concrete sleeper defects, their frequency of occurrence, and the quality of information provided by each of the condition assessment methods. The Residual Profile Number (RPN) from the FMEA showed which defects presented the highest unmitigated risks to continued rail operations. The top two most critical sleeper defects, longitudinal cracking and vertical cracks at the rail seat, are related to assessment methods that allow for maintenance planning requirements. Sleeper body abrasion was found to be the only defect that is currently not related to a method for detecting the condition well enough to sufficiently mitigate the residual risk to continued network operations. Methods that assess sleeper body abrasion need to be improved to meet maintenance planning requirements.