Silver‐based nanostructures have been widely used for biosensors and medical diagnostics due to their unique optical properties. In this chapter, we review the fundamentals of different novel diagnostics techniques, such as surface plasmon resonance, localized surface plasmon resonance, surface‐enhanced Raman spectroscopy, metal‐enhanced florescence and surface‐enhanced infrared absorbance spectroscopy, based on the unique plasmonic properties of silver nanostructures. The general methodology to synthesize and fabricate different silver nanostructures is also reviewed. Surface‐enhanced Raman spectroscopy has been used as an example to show the potential of Ag nanoparticle‐based diagnostic techniques in applications such as drug identification, biomarker tracing, DNA and RNA differentiation, virus and bacterial detection. The demonstrated Ag nanostructure‐based optical sensing techniques have not only high efficiency and sensitivity but also relatively simple equipment requirements and are economic – features which offer great potential for use in practical diagnostics.