Creatinine biosensors, based on both potentiometric and amperometric devices, have been created. However, there are significant problems still to be addressed, including the balance between sensitivity and selectivity, interference rejection and sensor stability. In addition, many devices still rely on a dual-sensor approach for creatine and creatinine subtractive measurements. However, creatinine biosensors appear close to attaining the performance goals necessary for their widespread application. This article looks at the operating principle and design of both potentiometric and amperometric creatinine biosensors, and shows how the design of these devices affects their performance.