Compared to the widely used compound semiconductor photoelectric sensors, all-silicon photoelectric sensors have the advantage of easy mass production because they are compatible with the complementary metal-oxide-semiconductor (CMOS) fabrication technique. In this paper, we propose an all-silicon photoelectric biosensor with a simple process and that is integrated, miniature, and with low loss. This biosensor is based on monolithic integration technology, and its light source is a PN junction cascaded polysilicon nanostructure. The detection device utilizes a simple refractive index sensing method. According to our simulation, when the refractive index of the detected material is more than 1.52, evanescent wave intensity decreases with the growth of the refractive index. Thus, refractive index sensing can be achieved. Moreover, it was also shown that, compared to a slab waveguide, the embedded waveguide designed in this paper has a lower loss. With these features, our all-silicon photoelectric biosensor (ASPB) demonstrates its potential in the application of handheld biosensors.