Fiber-optic biosensors based on localized surface plasmon resonance (LSPR) have the advantages of great biocompatibility, label-free, strong stability, and real-time monitoring of various analytes. LSPR fiber-optic biosensors have attracted extensive research attention in the fields of environmental science, clinical medicine, disease diagnosis, and food safety. The latest development of LSPR fiber-optic biosensors in recent years has focused on the detection of clinical disease markers and the detection of various toxic substances in the environment and the progress of new sensitization mechanisms in LSPR fiber-optic sensors. Therefore, this paper reviews the LSPR fiber-optic sensors from the aspects of working principle, structure, and application fields in biosensors. According to the structure, the sensor can be divided into three categories: traditional ordinary optical fiber, special shape optical fiber, and specialty optical fiber. The advantages and disadvantages of existing and future LSPR fiber-optic biosensors are discussed in detail. Additionally, the prospect of future development of fiber-optic biosensors based on LSPR is addressed.