Chitosan (CTS), a biocompatible and multifunctional material derived from chitin, has caught researchers' attention in electrochemical detection due to its unique properties. This review paper provides a comprehensive overview of the recent progress and applications of CTS-based electrochemical sensors in the analysis of pharmaceutical products and other types of samples, with a particular focus on the detection of medicinal substances. The review covers studies and developments from 2003 to 2023, highlighting the remarkable properties of CTS, such as biocompatibility, chemical versatility, and large surface area, that make it an excellent candidate for sensor modification. Combining CTS with various nanomaterials significantly enhances the detection capabilities of electrochemical sensors. Various types of CTS-based sensors are analyzed, including those utilizing carbon nanomaterials, metallic nanoparticles, conducting polymers, and molecularly imprinted CTS. These sensors exhibit excellent sensitivity, selectivity, and stability, enabling the precise and reliable detection of medications. The manufacturing strategies used for the preparation of CTS-based sensors are described, the underlying detection mechanisms are elucidated, and the integration of CTS sensors with transducer systems is highlighted. The prospects of CTS-based electrochemical sensors are promising, with opportunities for miniaturization, simultaneous detection, and real-time monitoring applications.