Heavy metal ions (HMIs) pose a serious threat to the environment and human body because they are toxic and non-biodegradable and widely exist in environmental ecosystems. It is necessary to develop a rapid, sensitive and convenient method for HMIs detection to provide a strong guarantee for ecology and human health. Ion-imprinted electrochemical sensors (IIECSs) based on nanomaterials have been regarded as an excellent technology because of the good selectivity, the advantages of fast detection speed, low cost, and portability. Electrode surfaces modified with nanomaterials can obtain excellent nano-effects, such as size effect, macroscopic quantum tunneling effect and surface effect, which greatly improve its surface area and conductivity, so as to improve the detection sensitivity and reduce the detection limit of the sensor. Hence, the present review focused on the fundamentals and the synthetic strategies of ion-imprinted polymers (IIPs) and IIECSs for HMIs detection, as well as the applications of various nanomaterials as modifiers and sensitizers in the construction of HMIIECSs and the influence on the sensing performance of the fabricated sensors. Finally, the potential challenges and outlook on the future development of the HMIIECSs technology were also highlighted. By means of the points presented in this review, we hope to provide some help in further developing the preparation methods of high-performance HMIIECSs and expanding their potential applications.