Terahertz (THz) waves, which fall between microwaves and infrared bands, possess intriguing electromagnetic properties of non-ionizing radiation, low photon energy, being highly sensitive to weak resonances, and non-polar material penetrability. Therefore, THz waves are extremely suitable for sensing and detecting chemical, pharmaceutical, and biological molecules. However, the relatively long wavelength of THz waves (303000 μm) compared to the size of analytes (1100 nm for biomolecules, <10 μm for microorganisms) constrains the development of THz-based sensors. To circumvent this problem, metasurface technology, by engineering subwavelength periodic resonators, has gained a great deal of attention to enhance the resonance response of THz waves. Those metasurface-based THz sensors exhibit high sensitivity for label-free sensing, making them appealing for a variety of applications in security, medical applications, and detection. The performance of metasurface-based THz sensors is controlled by geometric structure and material parameters. The operating mechanism is divided into two main categories, passive and active. To have a profound understanding of these metasurface-assisted THz sensing technologies, we review and categorize those THz sensors, based on their operating mechanisms, including resonators for frequency shift sensing, nanogaps for enhanced field confinement, chirality for handedness detection, and active elements (such as graphene and MEMS) for advanced tunable sensing. This comprehensive review can serve as a guideline for future metasurfaces design to assist THz sensing and detection.