Bacterial contamination is a public health concern worldwide causing enormous social and economic losses. For early diagnosis and adequate management to prevent or treat pathogen-related illnesses, extensive effort has been put into the development of pathogenic bacterial detection systems. Colorimetric sensing systems have attracted increasing attention due to their simple and single-site operation, rapid signal readout with the naked eye, ability to operate without external instruments, portability, compact design, and low cost. In this article, recent trends and advances in colorimetric systems for the detection and monitoring of bacterial contamination are reviewed. This article focuses on pathogen detection strategies and technologies based on reaction factors that affect the color change for visual readout. Reactions used in each strategy are introduced by dividing them into the following five categories: external pH change-induced pH indicator reactions, intracellular enzyme-catalyzed chromogenic reactions, enzyme-like nanoparticle (NP)-catalyzed substrate reactions, NP aggregation-based reactions, and NP accumulation-based reactions. Some recently developed colorimetric systems are introduced, and their challenges and strategies to improve the sensing performance are discussed.