The development of near-infrared II (NIR-II, 1000–1700 nm) technologies has opened new opportunities for biomedical applications, particularly in cancer diagnosis and therapy. Compared with conventional NIR-I systems (700–900 nm), NIR-II nanoplatforms offer deeper tissue penetration, reduced photon scattering, and minimal autofluorescence, enabling high-resolution, high-contrast imaging and improved therapeutic performance. A wide range of NIR-II-responsive nanostructures has been developed, including metal-based, carbon-based, semiconductor-based, hybrid/composite nanostructures, and organic fluorophores. These nanomaterials exhibit unique optical and physicochemical properties that support advanced applications such as fluorescence imaging (FLI), photothermal therapy (PTT), and photodynamic therapy (PDT), particularly in cancer theranostics. This review systematically summarizes recent advances and integration strategies of NIR-II functional nanostructures, with a particular focus on their roles in cancer imaging and image-guided therapy. However, key challenges associated with clinical translation including long-term toxicity, biodistribution, clearance, scalability, cost, and stability remain significant and are critically discussed. Finally, future perspectives are outlined, emphasizing the development of biocompatible, efficient, and clinically translatable NIR-II nanoplatforms.




