Hydrogen is considered a promising clean energy vector with the features of high energy capacity and zero-carbon emission. Water splitting is an environment-friendly and effective route for producing high-purity hydrogen, which contains two important half-cell reactions, namely, the anodic oxygen evolution reaction (OER) and the cathodic hydrogen evolution reaction (HER). At the heart of water splitting is high-performance electrocatalysts that efficiently improve the rate and selectivity of key chemical reactions. Recently, perovskite oxides have emerged as promising candidates for efficient water splitting electrocatalysts owing to their low cost, high electrochemical stability, and compositional and structural flexibility allowing for the achievement of high intrinsic electrocatalytic activity. In this review, we summarize the present research progress in the design, development, and application of perovskite oxides for electrocatalytic water splitting. The emphasis is on the innovative synthesis strategies and a deeper understanding of structure–activity relationships through a combination of systematic characterization and theoretical research. Finally, the main challenges and prospects for the further development of more efficient electrocatalysts based on perovskite oxides are proposed. It is expected to give guidance for the development of novel non-noble metal catalysts in electrochemical water splitting.