Boron neutron capture therapy (BNCT) is a next-generation radiotherapy that combines neutron beams with boron compounds that selectively accumulate in cancer cells. Because this therapy requires neutrons for irradiation, compact accelerator-based neutron source devices that can be installed in hospitals are being developed around the world. Clinical trials of several devices have been conducted in Japan, China, and South Korea. The most advanced device was approved by the Japanese regulatory authorities in 2020. As a result, BNCT with the device is being implemented as an insured therapy for recurrent head and neck cancer at two hospitals in Japan. Thus, the development of accelerator-based neutron generators is proceeding in the field of BNCT. However, much remains to be done to establish this therapy as a common cancer treatment and to make it available worldwide. Dosimetry methods in BNCT are one of the issues. In the treatment, the dose given to a patient by neutron irradiation has to be estimated accurately. However, it is difficult to measure neutrons accurately and in real time. Currently, the neutron dose delivered to patients during treatment is not measured. Instead, the current of the charged particles that irradiate the neutron target material is measured to indirectly evaluate the neutron fluence and dose. In addition, accurate dose estimation based on reactions with neutrons and various elements in a human body uses the Monte Carlo method, which is computationally time-consuming. To address these dosimetry issues, several neutron fluence and dose measurement methods are being developed. This review briefly describes the current dosimetry methods and then presents several methods under development that allow real-time neutron measurements applicable to BNCT.