This article presents a comprehensive overview of recent advancements in photonic crystal fiber (PCF)-based sensors, with a particular focus on the surface plasmon resonance (SPR) phenomenon for biosensing. With their ability to modify core and cladding structures, PCFs offer exceptional control over light guidance, dispersion management, and light confinement, making them highly suitable for applications in refractive index (RI) sensing, biomedical imaging, and nonlinear optical phenomena such as fiber tapering and supercontinuum generation. SPR is a highly sensitive optical phenomenon, which is widely integrated with PCFs to enhance detection performance through strong plasmonic interactions at metal-dielectric interfaces. The combination of PCF and SPR technologies has led to the development of innovative sensor geometries, including D-shaped fibers, slotted-air-hole structures, and internal external metal coatings, each optimized for specific sensing goals. These PCF-SPR-based sensors have shown promising results in detecting biomolecular targets such as excess cholesterol, glucose, cancer cells, DNA, and proteins. Furthermore, this review provides an in-depth analysis of key design parameters, plasmonic materials, and sensor models used in PCF-SPR configurations, highlighting their comparative performance metrics and application prospects in medical diagnostics, environmental monitoring, and chemical analysis. Thus, an exhaustive analysis of various sensing parameters, plasmonic materials, and sensor models used in PCF-SPR sensors is presented and explored in this article.