In engineering applications, the robustness and effectiveness of damage diagnostic imaging for guided wave-based structural health monitoring could be affected by the complexity of structures. In this study, an elliptical ring distribution probability-based diagnostic imaging algorithm is proposed to mitigate this effect using the estimated wave velocity and damage index. This algorithm improves the ability of damage localization by modifying the defect distribution probability of probability-based diagnostic imaging. The elliptical ring distribution probability of the presence of defect is used for each sensing path in the algorithm. The width of the elliptical ring distribution probability is determined by the range of estimated wave velocity. The amplitude of the elliptical ring distribution probability is determined by the damage index. The damage location is determined by the cross region of different elliptical rings for different sensing paths. The capability of the algorithm is validated by identifying damages at different locations on a complex composite fuselage panel. The results show that the proposed algorithm can identify a single damage accurately and it can identify multiple damages effectively as well.