The early cancer detection is of great significance to increase the patient’s survival rate and reduce the risk of cancer development. Surface enhanced Raman spectroscopy (SERS) technique, a rapid, convenient, nondestructive optical detection method, can provide a characteristic “fingerprint” information of target substances, even achieving single molecule detection. Its ultra-high detection sensitivity has made it become one of the most potential biochemical detection methods. Saliva, a multi-constituent oral fluid, contains the bio-markers which is capable of reflecting the systemic health condition of human, showing promising potential as an effect medium for disease monitoring. Compared with the serum samples, the collection and processing of saliva is safer, more convenient and noninvasive. Thus, saliva test is becoming the hotspot issues of the noninvasive cancer research field. This review highlights and analyzes current application progress within the field of SERS saliva test in cancer detection. Meanwhile, the primary research results of SERS saliva for the noninvasive differentiation of nasopharyngeal cancer, normal and rhinitis obtained by our group are shown.