Perovskite quantum dots (PQDs) have emerged as a promising class of luminescent nanomaterials for food safety monitoring due to their exceptional optical properties, compositional tunability, and defect-tolerant electronic structure. In recent years, PQD-based sensors have attracted increasing attention for the detection of food contaminants through fluorescence and electrochemiluminescence (ECL) signal transduction. This review provides a comprehensive overview of PQD-based fluorescent and ECL sensors developed for food safety monitoring. Fundamental material properties relevant to sensing performance, including surface chemistry, photoluminescence behavior, and charge transfer characteristics, are briefly discussed. Particular emphasis is placed on sensor design strategies, surface functionalization approaches, and signal transduction mechanisms governing fluorescence quenching, ratiometric responses, and ECL modulation. Recent advances in the detection of pesticides, mycotoxins, antibiotics, and other food-related contaminants are systematically analyzed, highlighting analytical performance, sensitivity, and selectivity in complex food matrices. Current challenges related to environmental stability, reproducibility, and practical applicability are also addressed. Finally, future perspectives are discussed to guide the rational design of robust PQD-based sensing platforms for reliable food safety monitoring.