Photothermal therapy (PTT) is a new type of tumor treatment technology that is noninvasive, repeatable, and does not involve radiation. Owing to the lack of real-time and accurate noninvasive temperature measurement technology in current PTT surgical procedures, empirical and open-loop treatment laser power control mode inevitably leads to overtreatment. Thermal radiation causes irreversible damage to normal tissue around cancer tissue and seriously affects the therapeutic effect of PTT and other therapies conducted at the same time. Therefore, real-time measurement and control of the temperature and thermal damage of the therapeutic target are critical to the success of PTT. To improve the accuracy and safety of PTT, we propose a multi-wavelength photoacoustic (PA) temperature feedback based PTT method and system. PA thermometry information at different wavelengths is mutually corrected, and the therapeutic light dose is regulated in real time to accurately control the treatment temperature. The experimental results on the swine blood sample confirm that the proposed method can realize real-time temperature measurement and control of the target area with an accuracy of 0.56 °C and 0.68 °C, demonstrating its good prospects for application.