Microneedles-based electrochemical sensing is a promising technology with potential uses in the detection of emerging biomarkers linked to a variety of illnesses, including infectious diseases and cancer, as well as continuous glucose monitoring for diabetes. The minimally invasive and convenient detection capabilities of microneedles make them valuable tools in biomedical research and clinical practice, enabling personalized and continuous monitoring of health parameters for improved disease management and healthcare outcomes. The developments in modification strategies, electronic integration, and fabrication techniques have accelerated the development of electrochemical microneedle sensors. The electrical and electrochemical behaviours of materials (such as metals, nanomaterials, and conducting polymers), which are essential for sensitive biosensors, are covered along with the requirements for creating microneedle-based biosensors. Wearable electrochemical sensors based on Microneedle sensing technologies offer a promising solution for continuous, real-time, minimally invasive, and painless monitoring of biochemical markers and therapeutic drugs. This has led to an expansion of sensor applications in environmental monitoring, healthcare, and personalized diagnosis. These advancements have collectively expanded the capabilities of electrochemical microneedle sensors, making them versatile platforms for continuous, decentralized health monitoring and personalized diagnostics. This chapter particularly emphasizes the materials, fabrication approaches and, finally, the microneedles-based electrochemical sensing platforms for the detection of emerging biomarkers of glucose, lactic acid, dopamine, etc. In addition, we anticipate the integration of microneedle sensors into a closed-loop system biodevice for a variety of uses, such as therapy and detection, as well as the realm of electrochemical sensors and electroanalytical techniques over the previous decades.