Seismic tube waves, produced by flexure of the well boundary, pressure changes in the fluid in the well, and deformation of the material immediately surrounding the well, are particularly sensitive to variations in the state of the well. We evaluate a direct approach for generating and observing tube waves as a means of detecting well damage. While we find that it can be difficult to reliably excite observable tube waves without a very strong surface source, time-frequency techniques can be employed to increase the detectability of tube wave reflections. New technologies, particularly distributed acoustic sensing, hold great promise for evaluating well integrity by monitoring tube waves, temperature changes, and seismic noise due to well deformation and fluid leakage.