The puffer fish has won the hearts of diners because of its rich nutrition and delicious meat. However, tetrodoxin (TTX) is extremely toxic and has stable physical and chemical properties. It is difficult to inactivate it by conventional cooking methods. If it is inadvertently eaten or improperly handled, it can easily lead to poisoning accidents. TTX poses a great threat to ecological security, food safety and public safety. Therefore, rapid, efficient, sensitive and specific detection technology is an important measure to effectively prevent and respond to TTX poisoning incidents. After years of exploration and research, researchers have gradually formed traditional and classic bioassay methods, immunoassay methods and chemical assay methods. These three types of detection methods have their own advantages and disadvantages. According to the actual application scenarios and combined with their detection characteristics, the three types of methods have been used independently or in combination to varying degrees. The difficulty of TTX detection lies in the small content and many interference factors in the sample. The traditional detection methods still have the disadvantages of weak anti-interference ability and insufficient sensitivity. The emergence of aptamers, a new molecular recognition element, has opened up a new path for TTX detection. In particular, the combination of aptamers with biosensor platforms such as fluorescence technology and SERS technology makes it possible to achieve rapid, ultra-sensitive and real-time detection of TTX.