The extensive use of pesticides represents a risk to human health. Consequently, legal frameworks have been established to ensure food safety, including control programs for pesticide residues. In this context, the performance of analytical methods acquires special relevance. Such methods are expected to be able to determine the largest number of compounds at trace concentration levels in complex food matrices, which represents a great analytical challenge. Technical advances in mass spectrometry (MS) have led to the development of more efficient analytical methods for the determination of pesticides. This review provides an overview of current analytical strategies applied in pesticide analysis, with a special focus on MS methods. Current targeted MS methods allow the simultaneous determination of hundreds of pesticides, whereas non-targeted MS methods are now applicable to the identification of pesticide metabolites and transformation products. New trends in pesticide analysis are also presented, including approaches for the simultaneous determination of pesticide residues and other food contaminants (i.e., mega-methods), or the recent application of techniques such as ion mobility–mass spectrometry (IM–MS) for this purpose.