The chiral compounds may be biomarker candidates in human metabolism, which indicates the health status of humans. There are many applications in LC/MS that show that chiral small molecules are promising biomarkers for human diseases. Both clinical and commercial analyses of chiral metabolites are necessary due to the enantiomeric ratios of chiral molecules in biological samples may show both human health status and diseases. This review provides current and advanced LC/MS techniques for the separation and analysis of chiral molecules as disease biomarkers. In particular, sample preparation and chromatographic analysis of potential chiral biomarkers in biological samples are presented. The preparation and applications of several chiral columns used in enantiomeric separation of chiral metabolites/biomarkers by advanced LC/MS techniques are discussed. The improvement of these analyses will enable both the discovery of new chiral biomarkers and the prognosis of human diseases.
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