The invention provides a detection device and detection system for a medical accelerator. The detection device comprises a first fixed portion, a second fixed portion, a first sliding portion, at least one first driven wheel, a second sliding portion, at least one second driven wheel, at least one driving wheel, a mounting bracket, a third fixed portion, a third sliding portion, a fourth fixed portion, a fourth sliding portion and an ionization chamber, wherein the first fixed portion and the second fixed portion are located at two sides of the bottom end of an accelerator support respectively, the first sliding portion is slidably connected with the first fixed portion; the at least one first driven wheel is installed at the first sliding portion, the second sliding portion is slidably connected with the second fixed portion, the at least one second driven wheel is installed at the second sliding portion, the at least one driving wheel is installed at the second sliding portion, the mounting bracket is connected with the first sliding portion and the second sliding portion, the third fixed portion is mounted at the top end of the mounting bracket and parallel to a horizontal plane, the third sliding portion is slidably connected with the third fixed portion, the fourth fixed portion is installed at the third sliding portion and vertical to the third sliding portion, the fourth sliding portion is slidably connected with the fourth fixed portion, and the ionization chamber is installed at the bottom end of the fourth sliding portion and acquires radiation data of the accelerator. With the detection device and detection system provided by the invention adopted, harm to testing personnel can be reduced, and real-time detection for the medical accelerator can be realized.