Real-time multi-axis distributed tactile sensing is a critical capability if robots are to perform stable gripping and dexterous manipulation, as it provides crucial information about the sensor–object interface. In this paper, we present an optical-based six-axis tactile sensor designed in a fingertip shape for robotic dexterous manipulation. The distributed sensor can precisely estimate the local XYZ force and displacement at ten distinct locations and provide the global XYZ force and torque measurements. Its compact size, comparable to that of a human thumb, and minimal thickness allow seamless integration onto existing robotic fingers, eliminating the need for complex modifications to the gripper. The proposed sensor design uses a simple, low-cost fabrication method. Moreover, the optical transduction approach uses light angle and intensity sensing to infer force and displacement from deformations of the individual sensing units that form the overall sensor, providing distributed six-axis sensing. The local force precision at each sensing unit in the X, Y, and Z axes is 20.89 mN, 19.19 mN, and 43.22 mN, respectively, over a local force range of approximately ±1.5 N in X and Y and 0 to −2 N in Z. The local displacement precision in the X, Y, and Z axes is 56.70 μm, 50.18 μm, and 13.83 μm, respectively, over a local displacement range of ±2 mm in the XY directions and 0 to −1.5 mm in Z (i.e., compression). Additionally, the sensor can measure global torques, Tx, Ty, and Tz, with a precision of of 1.90 N-mm, 1.54 N-mm, and 1.26 N-mm, respectively. The fabricated design is showcased by integrating it with an OnRobot RG2 gripper and illustrating real-time measurements during in simple demonstration task, which generated changing global forces and torques.