Precise detection and effective treatment are crucial to prolong cancer patients' lives. Surface-enhanced Raman scattering (SERS) imaging coupled with photothermal therapy has been considered a precise and effective strategy for cancer theranostics. Nevertheless, Raman reporters employed in the literature usually possessed multiple shift peaks in the fingerprint region, which are overlapped with background signals from endogenous biological molecules. Herein, we fabricated a new kind of bioorthogonal Raman reporter and aptamer functionalized SERS nanotags. The SERS nanotags demonstrated a strong Raman signal at 2205 cm −1 in the biologically Raman-silent region and recognized MCF-7 breast cancer cells for Raman imaging with high specificity. Laser irradiation induced serious toxicity of MCF-7 cells due to the excellent photothermal capability of the SERS nanotags. After intravenous administration of the SERS nanotags, tumor Raman spectral detection and mapping in living mice were successfully achieved. Further in vivo antitumor experiments manifested that the aptamer-modified SERS nanotags significantly restrained tumor growth after laser irradiation with 99% inhibition rate and good biocompatibility. These results clearly revealed that the SERS nanotags could serve as a novel and precise theranostic platform for in vivo cancer diagnosis and photothermal therapy.P recise diagnosis and effective treatment are crucial to enhance cancer patients' survival rates and quality of life. Nevertheless, conventional detection approaches of cancer including biopsy, ultrasonography, X-ray computed tomography (CT), and magnetic resonance imaging (MRI) suffer from inherent drawbacks such as low sensitivity and specificity which restrict their clinical applications in early diagnosis. 1−3 Another emerging imaging technique known as positron emission tomography (PET) combined with CT or MRI has demonstrated higher sensitivity and accuracy than traditional imaging methods but requires high cost and radioactive materials with potential health hazards. 4,5 In recent years, surface-enhanced Raman scattering (SERS) imaging has attracted tremendous attention in biomedical fields, owing to its ultrahigh sensitivity (up to 10 −15 M), high signal-tobackground ratio, specific fingerprint signature, photostability, and excellent multiplex capability. 6−12 These advantages give SERS imaging great promise for accurate cancer detection. 13−17 In 2008, Nie's group first employed SERS nanotags for cancer targeting and spectroscopic detection in xenograft tumor models. 18 Gambhir et al. first applied spectrally unique SERS nanotags for in vivo deep-tissue multiplex imaging. 19,20 Subsequently, they designed a novel nanotag with triple modality imaging capability and utilized SERS imaging to distinguish the brain tumor margin in surgical resection. 21 Recently, they presented a small-animal Raman imaging system for rapid, wide-area, high-spatial resolution and spectroscopic imaging. 22 Kircher et al. has demonstrated that SERS nanotagguided sur...