The contamination of aquatic environments by endocrine-disrupting chemicals (EDCs) endangers both environmental and human health. Traditional detection methods, such as chromatography-mass spectrometry (GC-MS) or high-performance liquid chromatography (HPLC), though accurate, are expensive, time-consuming, and require sophisticated equipment. Consequently, there is increasing interest in identifying efficient, biology-based biomarker alternatives. Nitric Oxide (NO) has emerged as a promising biomarker for detecting EDCs because of its role in cellular signalling and oxidative stress responses to environmental pollutants. While research indicates NO's potential for water quality monitoring, its use as a standard biomarker remains to be explored and validated further. This review examines the biological mechanisms underlying NO's response to EDC exposure, its application in environmental monitoring, and the benefits and challenges of NO-based assessment methods. The paper also addresses existing knowledge gaps,including the absence of standardised methods for NO monitoring, limited understanding of species-specific responses, and uncertainties related to long-term environmental changes. Additionally, it suggests future research directions to incorporate NO as a biomarker for water quality evaluation. Using NO as a biomarker for EDCs could improve water pollution surveillance and help mitigate ecological and health risks associated with endocrine-disrupting pollutants in aquatic environments.