Rapid, sensitive, and accurate detection of adrenoceptor agonists is a significant research topic in the fields of food safety and public health. Immunoassays are among the most widely used methods for detecting adrenoceptor agonists. In recent years, surface-enhanced Raman spectroscopy combined with immunoassay (SERS-IA) has become an effective technique for improving detection sensitivity. This review focuses on the innovation of Raman reporter molecules and substrate materials for the SERS-IA of adrenoceptor agonists. In addition, it also investigates the challenges involved in potentially applying SERS-IA in the detection of adrenoceptor agonists. Overall, this review provides insight into the design and application of SERS-IA for the detection of adrenoceptor agonists, which is critical for animal-derived food safety and public health.