Many of the recent developments in optical nanosensors have led to tuning the analytical performance of these devices to physiological concentration ranges. Optical nanosensors that measure amplitude, energy, polarization, decay time and decay phase of absorption, phosphorescence, fluorescence, Raman scattering, refraction, interference, and dispersion are extensively used for the detection of pharmaceuticals. The use of highly selective and sensitive nanomaterials-based optical sensors for the detection of disease biomarkers has maximized the chances of early-stage diagnosis of various diseases. Optical nanosensors have attracted a lot of interest for quantifying and measuring disease biomarkers, small molecule proteins, and peptides, as well as for ion concentrations and drug detection. This chapter covers the recent advances in terms of fiber optic-based plasmonic nanosensors along with optical spectroscopy, such as luminescence or colorimetric spectroscopy, and their applications in pharmaceuticals and medicinal biology. © 2019 Elsevier Inc. All rights reserved.