Early and precise diagnosis of neurodegenerative disorders like Alzheimer's (AD) and Parkinson's (PD) is crucial for slowing their progression and enhancing patient outcomes. Exosomal microRNAs (miRNAs) are emerging as promising biomarkers due to their ability to reflect the diseases' pathology, yet their low abundance poses significant detection hurdles. This review article delves into the burgeoning field of electrochemical biosensors, designed for the precise detection of exosomal miRNA biomarkers. Electrochemical biosensors offer a compelling solution, combining the sensitivity required to detect low-abundance biomarkers with the specificity needed to discern miRNA profiles distinctive to neural pathological states. We explore the operational principles of these biosensors, including the electrochemical transduction mechanisms that facilitate miRNA detection. The review also summarizes advancements in nanotechnology, signal enhancement, bioreceptor anchoring, and microfluidic integration that improve sensor accuracy. The evidence of their use in neurodegenerative disease diagnosis is analyzed, focusing on the clinical impact, diagnostic precision, and obstacles faced in practical applications. Their potential integration into point-of-care testing and regulatory considerations for their market entry are discussed. Looking toward the future, the article highlights forthcoming innovations that might revolutionize early diagnostic processes. Electrochemical biosensors, with their impressive sensitivity, specificity, and point-of-care compatibility, are on track to become instrumental in the early diagnosis of neurodegenerative diseases, possibly transforming patient care and prognosis.