Leakage in heat exchanger tubes can result in unreliable products and dangerous situations, which could cause great economic losses. Along with fast development of modern acoustic detection technology, using acoustic signals to detect leakage in heat exchange tube has been gradually accepted and considered with great potential by both industrial and research societies. In order to further advance the development of acoustic signal detection technology and investigate better methods for leakage detection in heat exchange tube, in this paper, firstly, we conduct a short overview of the theory of acoustic signal detection on heat exchanger tube, which had already been continuously developed for a few decades by researchers worldwide. Thereafter, we further expound the advantages and limitations of acoustic signal detection technology on heat exchanger tube in four aspects:1) principles of acoustic signal detection,2) characteristics of sound wave propagation in heat exchanger tube, 3) methods of leakage detection, and 4) leakage localization in heat exchanger tube.