Internal leakage within the valve body constitutes a severe potential safety hazard in industrial fluid control systems, attributable to its high concealment and the resultant difficulty in detection via conventional methodologies. Acoustic emission (AE) technology, functioning as an efficient non-destructive testing approach, is capable of capturing the transient stress waves induced by leakage, thereby furnishing an effective means for the real-time monitoring and quantitative assessment of internal leakage within the valve body. This paper conducts a systematic review of the theoretical foundations, signal-processing methodologies, and the latest research advancements related to the technology for detecting internal leakage in the valve body based on acoustic emission. Firstly, grounded in Lechlier’s acoustic analogy theory, the generation mechanism of acoustic emission signals arising from valve body leakage is elucidated. Secondly, a detailed analysis is conducted on diverse signal processing techniques and their corresponding optimization strategies, encompassing parameter analysis, time–frequency analysis, nonlinear dynamics methods, and intelligent algorithms. Moreover, this paper recapitulates the current challenges encountered by this technology and delineates future research orientations, such as the fusion of multi-modal sensors, the deployment of lightweight deep learning models, and integration with the Internet of Things. This study provides a systematic reference for the engineering application and theoretical development of the acoustic emission-based technology for detecting internal leakage in valves.