Hydromorphone, a semi-synthetic derivative of morphine, is being used in the treatment of moderate to severe cancer-related and post-operative pain. It is also one of the most commonly prescribed drug that is often abused. Hence, its detection in biological samples and tissues is important for legal and therapeutic reasons. The purpose of this review is to give a brief description of the various non-chromatographic and chromatographic analytical techniques, namely immunoassays, thin layer chromatography, high performance liquid chromatography, liquid chromatography/mass spectrometry, gas chromatography/mass spectrometry and capillary electrochromatography, that have been used by analysts to assay hydromorphone from the early 1970s to present. This review aims to help the analytical community make efficient choices between various analytical methodologies based on concrete parameters of reliability, sensitivity, specificity, precision, accuracy, cost and potential for automation.