The combinatorial chemical synthesis offers in vitro aptamer generation with limitless aptamer selection for various analytes. Additionally, aptamer has quite many outstanding properties as the biomolecular recognition elements, thus competing with traditional affinity ligands (enzyme, antibodies, lectins etc.) in biological and medicine employments. This article reviews the advancements in electrochemical aptasensors for biomolecule monitoring, emphasizing the efficient detection strategies of sandwich structure formation using two recognition elements to capture and label target respectively, EIS measuring the electronic transfer resistance change, the aptamer conformation change triggering the electrochemical signal on/off and target molecules displacing electroactive markers.