<p>Ochratoxin A, an extremely toxic mycotoxin produced by various fungi, is one of the most common contaminants of agricultural products such as cereals, nuts, coffee, and wine. Due to its nephrotoxicity, hepatotoxicity, teratogenicity, and immunotoxicity, together with the difficulty of its removal from food products, it poses a significant risk to human health worldwide. Its relevance in public health has gained growing attention mainly because of its potential role as a carcinogen. Cancer, as the second leading cause of death in the Czech Republic, has been increasingly studied in relation to ochratoxin A (OTA) exposure. Recent investigations (2022–2025) have reported elevated OTA levels in selected food and biological samples, and some studies have explored biomarkers of OTA exposure in patients with renal and hepatic diseases. These findings suggest a potential association between OTA exposure and cancer risk. However, causality has not been established, as confounding factors such as diet, alcohol consumption, smoking, and genetic predisposition may also contribute. As cancer rates rise, the need for effective detection methods has become more critical. Biosensors represent a simple, smart, portable, low-cost and rapid method for the detection of mycotoxins, including OTA. This article highlights the emergence of innovative biosensor diagnostics as a promising solution for rapid and sensitive detection of OTA in food and environmental samples. We discuss different types of biosensors, including immunosensors, genosensors, and sensors using molecularly imprinted polymers, detailing their mechanisms, advantages, and limitations in OTA detection.</p>