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Recent studies have demonstrated the ability of semiconducting nanowire (NW) field-effect transistors (FETs) to serve as highly sensitive label-free sensors for biochemicals, including small molecules, proteins, and nucleic acids. The nanoscale confinement of the channel current in concert with the large-surface area-to-volume ratio enables charged molecules bound to the surface to effectively gate the device. Functionalization of the NW surface with specific receptors therefore enables direct electronic detection of particular molecules of interest. The original work in the field relied on NWs grown by the chemical vapor deposition method, which require hybrid bottom-up fabrication processes for device realization. The lack of reproducibility with these techniques and the associated inability to leverage the central advantage of complementary MOSFETs, namely, very large scale integration, have recently led a number of groups to create NW sensors using only traditional top-down fabrication techniques. In this paper, we focus primarily on these most recent studies and discuss necessary future studies as dictated by experimental and theoretical considerations.