Recent advances in the field of microneedle devices are having an impact on both diagnostic and therapeutic approaches to sustaining healthy populations globally. Whether this is for improving drug and vaccine efficacy or for continuous sensing of key molecular indicators, the past five years have seen increased activity in both the academic and commercial sectors. In this Perspective, we focus on solid microneedle biosensors and discuss the advantages of these devices over alternative clinical diagnostic platforms as well as the technical challenges presented. We will emphasize how their use in continuous measurement of molecules in vivo is made possible with a minimally invasive technique that is simple to perform. This Perspective describes the function and current state of microneedle sensor arrays for the in vivo measurement of both endogenous molecules such as glucose and lactate and drugs such as penicillin.