The prevalence of myopia, especially high myopia, continues to increase in several parts of the world. Thus, the use of biomarkers for early myopia detection would be highly valuable for clinical practice aiding in the prevention and myopia control management. The identification of biomarkers that can predict the risk of myopia development, severity of myopia, and treatment response are of paramount significance. In this review, we present the current state of research on biomarkers and myopia, highlighting the challenges and opportunities in biomarkers research for myopia. Although myopia biomarkers may have a role as early indicators of myopia or treatment response, the adoption of biomarkers into myopia clinical practice may only be done when tests have high accuracy, are easily measurable, minimally invasive, and acceptable to parents, children, and eye care professionals. Large consortia studies are necessary to validate biomarkers and translate evidence into clinical practice.