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Since the electrogenerated chemiluminescence (ECL) of silicon quantum dots (QDs) was reported in 2002, a series of QDs with different sizes, components, and shapes has been extensively studied as ECL emitters for biosensors. Lately, near-infrared (NIR) ECL analysis has emerged as an alternative to traditional visible-range ECL bioassays, especially in some complex biological systems. This is because the NIR spectral region could provide a “clear window” to effectively fulfill the requirement of interference-free sensing. Among the present reported ECL emitters, QDs hold great promise as NIR ECL emitters owing to their size or surface-dependent luminescence and photochemical stability. This review presents a general picture of the latest advances and developments related to QDs for NIR ECL emitters. It briefly covers the synthetic strategies of NIR QDs and the advances in QD-based NIR ECL and related biosensing methodologies. Finally, we conclude with a look at the future challenges and prospects in the development of QD-based NIR ECL.