Procalcitonin (PCT) is a reliable biomarker for diagnosing and monitoring bacterial infections and sepsis. PCT exhibits good stability both in vivo and in vitro, and its levels drastically increase in response to bacterial infection or inflammatory reactions in the human body, making it a dependable indicator for sepsis diagnosis and monitoring with significant implications for clinical diagnosis and treatment guidance. Currently, immunosensors are widely utilized in PCT detection due to their high sensitivity and low detection limits. Noble metals, because of their excellent electronic conductivity, biocompatibility, and superior physicochemical properties, are extensively combined with other materials to play a pivotal role in the construction of PCT immunosensors. This review summarizes the research progress on PCT antigen immunosensors based on noble metal composite materials, encompassing the classification and principles of immunosensors. Starting from noble metals, which are widely used as electrode materials in sensors, the review categorizes and discusses the carbon materials, metal oxides, metal sulfides, and other composites with noble metals. The review also elaborates on the influence of sensitive materials on the performance of immunosensors. Finally, the review discusses and anticipates the challenges and future opportunities for the research on PCT antigen immunosensors using noble metal-composite nanomaterials, providing new insights and directions for their application in the treatment and clinical management of sepsis and other diseases.