Electrocardiography (ECG) is vital in diagnosing and preventing cardiovascular diseases (CVDs), which is the third leading cause of global mortality. Real-time ECG monitoring helps understand athletes’ physical conditions during training, thereby optimizing their performance. However, the accuracy of ECG signals from traditional ECG devices can be influenced by various factors, notably body movement, which can significantly disturb the electrode–skin impedance and the signal quality. Consequently, there is a pressing demand for portable, compact, and biocompatible real-time ECG monitoring devices with low noise level. The creation of flexible, skin-adhesive, and anti-motion interference electrodes, coupled with advancements in post noise reduction algorithms, has emerged as effective strategies. This review commences with an overview of typical ECG electrodes, followed by an exploration of recent developments in dry electrodes, which demonstrate considerable potential for anti-motion interference monitoring. Then, the prevalent circuits and modules used for signal acquisition and processing are discussed. Additionally, we delve into the causes of signal noise and effective methods of noise reduction. Lastly, we address future challenges and research directions in the field of anti-motion interference ECG monitoring.