<p>Public health emergencies increasingly threaten human health and socio-economic stability, necessitating enhanced monitoring and early warning capabilities to effectively prevent and mitigate public health risks. Real-time detection devices, through precise detection and dynamic monitoring enabled, play a crucial role in preventing disease outbreaks and reduce the spread of harmful substances. Among these, paper-based optical detection devices have emerged as one of the most promising strategies in the field of point-of-care testing (POCT), owing to their advantages such as portability, low cost, foldability, and visual results. This article systematically reviews the research progress and key challenges of paper-based optical detection devices. Firstly, various types of paper-based detection devices are outlined. Then, the optical sensing methods, recognition elements, and their loading techniques involved in these devices are combed in detailed. Subsequently, specific applications of paper-based optical detection devices in detecting foodborne pathogens, viruses, and heavy metals are summarized. Finally, challenges faced by paper-based optical detection devices and their future prospects are also discussed. This perspective offers researchers a unique viewpoint for developing portable and cost-effective paper-based optical detection devices.</p> Graphical Abstract <p></p>