Perfluorooctanoic acid (PFOA) is a new type of organic pollutant in wastewater that is persistent, toxic, and accumulates in living organisms. The development of rapid and sensitive analytical methods to detect PFOA in environmental media is of great importance. Fluorescence detection has the advantages of high efficiency and low cost, in which fluorescent probes have excellent fluorescence properties, excellent bio-solubility, and remarkable photostability. It is necessary to review the fluorescence detection routes for PFOA. In addition, the up-conversion of fluorescent materials (UCNPs), as fluorescent materials to prepare fluorescent probes with, has significant advantages and also attracts the attention of researchers, however, reviews related to their application in detecting PFOA and comparing them with other routes are rare. Furthermore, there are many strategies to improve the performance of up-conversion fluorescent probes including SiO modification and amino modification. These strategies can enhance the detection effect of PFOA. Thus, this work reviews the types of fluorescence detection, the design, and synthesis of UCNPs, their recognition mechanism, properties, and their application progress. Moreover, the development trend and prospects of these detection probes are given.