<p>Accurate analysis of pharmaceutical and toxic molecules is crucial for public health and safety. Nanozymes, nanomaterials with enzyme-like catalytic activities, have emerged as transformative tools to address this need. This review begins by classifying nanozymes and defining their core properties, followed by a systematic summary of how they integrate with major detection technologies, including colorimetry, fluorescence, electrochemistry, immunoassays, surface-enhanced Raman spectroscopy (SERS), and emerging multimodal techniques to enhance analytical performance. It then presents specific applications across diverse pharmaceutical and toxic targets, such as antibiotics, pesticides, traditional Chinese medicine components, toxins, and drug metabolites. The review further addresses critical challenges, including catalytic efficiency, selectivity, and biocompatibility, and outlines future directions for rational design and intelligent diagnostics. By providing a comprehensive overview of recent advances and persistent hurdles, this review aims to pave the way for continued innovation and practical translation in the field of nanozyme-based detection.</p> Graphical Abstract <p></p>