Surface acoustic wave (SAW) sensors have great advantages in real-time and in-situ gas detection due to their wireless and passive characteristics. Using nanostructured sensing materials to enhance the SAW sensor’s responses has become a research focus in recent years. In this paper, solution-processed PbS colloidal quantum dots (CQDs) were integrated into quartz SAW devices for enhancing the performance of NO2 detection operated at room temperature. The PbS CQDs were directly spin-coated onto ST-cut quartz SAW delay lines, followed by a ligand exchange treatment using Pb(NO3)2. Upon exposure to 10 ppm of NO2 gas, the sensor coated with untreated PbS CQDs showed response and recovery times of 487 s and 302 s, and a negative frequency shift of -2.2 kHz, mainly due to the mass loading effect caused by the absorption of NO2 gas on the surface of the dense CQD film. Whereas the Pb(NO3)2-treated sensor showed fast response and recovery times of 45 s and 58 s, and a large positive frequency shift of 9.8 kHz, which might be attributed to the trapping of NO2 molecules in the porous structure and thus making the film stiffer. Moreover, the Pb(NO3)2-treated sensor showed good stability and selectivity at room temperature.