Economic development has raised concerns about human healthcare and disease prevention from its early stages. In that regard, the detection of biomarkers is crucial for early diagnosis of diseases, and it is an essential tool for managing various health conditions. The clinical diagnostics industry is worth hundreds of billions of dollars and has been expanding. However, the traditional methods for biomarkers detection are high-cost and time-consuming. Also, they usually require highly trained personnel and complex instrumental processes, only providing a centralized medical diagnosis system in large hospitals or specialized facilities. In contrast, a chemosensor is a smart molecular analytical device designed to sense an analyte to generate a detectable signal and to offer direct diagnosis without complex instruments or systems. Moreover, electrochemiluminescence (ECL) possesses distinct advantages such as low-costs, simplicity, and portability. ECL has become a useful technique and has been widely applied in many fields, from basic research to practical applications. Chemosensors coupled with ECL can provide compelling advantages over conventional approaches, such as rapid response time, higher sensitivity, and selectivity. This minireview aims to highlight recent representative studies on ECL-based chemosensors for clinical applications. It provides a general overview of the design and structure of ECL-based chemosensors, and also covers the general problems and challenges. The presented content may prove to be useful for discovering new sensor concepts or extension of existing biomarker detection strategies.