Ratiometric electrochemical sensors are renowned for their dual-signal processing capabilities, enabling automatic correction of background noise and interferences through built-in calibration, thus providing more accurate and reproducible measurements. This characteristic makes them highly promising for food analysis. This review comprehensively summarizes and discusses the latest advancements in ratiometric electrochemical sensors and their applications in food analysis, emphasizing their design strategies, detection capabilities, and practical uses. Initially, we explore the construction and design strategies of these sensors. We then review the detection of various food-related analytes, including nutrients, additives, metal ions, pharmaceutical and pesticide residues, biotoxins, and pathogens. The review also briefly explores the challenges faced by ratiometric electrochemical sensors in food testing and potential future directions for development. It aims to provide researchers with a clear introduction and serve as a reference for the design and application of new, efficient ratiometric electrochemical sensors in food analysis.