The high sensitivity of optical detection techniques and the highly specific reactions between antibodies and antigens mean that optical immunoassays have attracted much interest in the fields of protein, hormone, drug, and microorganism detection, without the need for complex separation and extraction steps. The immobilization of an antibody on a solid support is a crucial step for optical immunoassays. This review surveys the latest advances in current antibody immobilization techniques in detail, including physical adsorption, covalent attachment, bioaffinity immobilization, and some recently developed methods. Furthermore, specific consideration is given to oriented immobilization, which may improve the homogeneous surface covering the accessibility of the active site and surface coverage, and the analytical performance of immunoassays. Finally, new perspectives for antibody immobilization techniques in optical immunoassays are outlined.