The detection of ionizing radiation such as X-ray, γ-ray, α-particle, and neutrons has been widely required in medical and industrial areas. Perovskite semiconductor detectors are arousing widespread interest and achieving significant progresses in this area. Unique material strengths, such as large attenuation coefficient, defect tolerant nature, balanced carrier mobilities, and feasible preparation techniques, make perovskite semiconductor detector a strong competitor to existing commercial products. Inspired by the booming development of this area, we review the current achievements of ionizing radiation detection with perovskite semiconductors. Firstly, a comprehensive summary of the device preparation techniques is provided, followed by a profound discussion of the detector physics. Then, the broad applications of perovskite semiconductor detectors are illustrated. Finally, we give an outlook of the current challenges pending to be tackled for commercialized applications. We believe the perovskite semiconductor detectors will be new blood to the current ionizing radiation detection market.