The measurement of stress in a structure presents considerable interest in many fields of engineering. In this paper, the diagnostic potential of nonlinear elastic guided waves in a prestressed plate is investigated. To do so, an analytical model is formulated accounting for different aspects involved in the phenomenon. The fact that the initial strains can be finite is considered using the Green Lagrange strain tensor, and initial and final configurations are not merged, as it would be assumed in the infinitesimal strain theory. Moreover, an appropriate third-order expression of the strain energy of the hyperelastic body is adopted to account for the material nonlinearities. The model obtained enables to investigate both the linearized case, which gives the variation of phase and group velocity as a function of the initial stress, and the nonlinear case, involving second-harmonic generation as a function of the initial state of stress. The analysis is limited to Rayleigh-Lamb waves propagating in a plate. Three cases of initial prestress are considered, including prestress in the direction of the wave propagation, prestress orthogonal to the direction of wave propagation, and plane isotropic stress.