Liquid biopsy represents a groundbreaking technology enabling the detection, analysis, and monitoring of circulating targets in body fluids, such as blood, to acquire crucial molecular insights into tumorigenesis and progression mechanisms. Offering non‐invasiveness and real‐time capabilities, liquid biopsy facilitates the tracking of tumor evolutionary dynamics and exploration of tumor heterogeneity, thereby holding immense value for tumor diagnosis, personalized treatment, and prognostication. Therefore, an effective analysis of circulating targets in body fluids is essential. However, the complexity of biological systems poses notable challenges to achieving high sensitivity and accuracy in liquid biopsy. Aptamers possess inherent advantages of high specificity and affinity, with the added benefit of modifiability and design flexibility to enhance their performance under different practical conditions, rendering them ideal recognition elements for liquid biopsy. This review provides a comprehensive summary of design strategies for aptamer applications in liquid biopsy, including advanced aptamer screening strategies, aptamer‐based recognition designs, and signal amplification techniques. Ultimately, we present an outlook into the future prospects and directions of aptamer applications in the liquid biopsy.