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We develop an “all-in-one” fiber-optic theranostics probe (AFOT) with the combination of nitroreductase (NTR) fluorescent molecules and graphene/gold nanostar (Gr/AuNS) nanomaterials to enable the integrated strategy for tumor sensing and treatment. The sensor can not only detect the hypoxic signal in the tumor within ten seconds with high sensitivity, but also realize the identification of the tumor margin mediated by the high spatio-temperal manipulation. Using the same fiber sensor, the xenograft tumors of mice can be treated through the self-photothermal therapy (PTT) soon after detection, resulting in a high cure rate of 83.33% without the risk of recurrence. More importantly, the AFOT is highly adaptable to the conventional medical imaging techniques, such as laparoscope, magnetic resonance, and ultrasound imaging, which facilitates the imaging-assisted navigation.