Alzheimer’s disease (AD) is a growing global concern, exacerbated by an aging population and the high costs associated with traditional detection methods. Recent research has identified speech data as valuable clinical information for AD detection, given its association with the progressive degeneration of brain cells and subsequent impacts on memory, cognition, and language abilities. The ongoing demographic shift toward an aging global population underscores the critical need for affordable and easily available methods for early AD detection and intervention. To address this major challenge, substantial research has recently focused on investigating speech data, aiming to develop efficient and affordable diagnostic tools that align with the demands of our aging society. This paper presents an in-depth review of studies from 2018–2023 utilizing speech for AD detection. Following the PRISMA protocol and a two-stage selection process, we identified 85 publications for analysis. In contrast to previous literature reviews, this paper places a strong emphasis on conducting a rigorous comparative analysis of various Artificial Intelligence (AI) based techniques, categorizing them meticulously based on underlying algorithms. We perform an exhaustive evaluation of research papers leveraging common benchmark datasets, specifically ADReSS and ADReSSo, to assess their performance. In contrast to previous literature reviews, this work makes a significant contribution by overcoming the limitations posed by the absence of standardized tasks and commonly accepted benchmark datasets for comparing different studies. The analysis reveals the dominance of deep learning models, particularly those leveraging pre-trained models like BERT, in AD detection. The integration of acoustic and linguistic features often achieves accuracies above 85%. Despite these advancements, challenges persist in data scarcity, standardization, privacy, and model interpretability. Future directions include improving multilingual recognition, exploring emerging multimodal approaches, and enhancing ASR systems for AD patients. By identifying these key challenges and suggesting future research directions, our review serves as a valuable resource for advancing AD detection techniques and their practical implementation.