A microfiber with large evanescent field encapsulated in PDMS is proposed and demonstrated for ultrasound sensing. The compact size and large evanescent field of microfiber provide an excellent platform for the interaction between optical signal and ultrasound wave, exhibiting a high sensitivity of 3.5 mV/kPa, which is approximately 10 times higher than the single-mode fiber sensor. Meanwhile, a phase feedback stabilization module is introduced into the coherent demodulation system for long-term stable measurement. In addition, a photoacoustic tomography experiment with the microfiber ultrasound sensor is implemented to verify the excellent performance on imaging, with the depth of 12 mm, the highest lateral resolution of 65 μm and axial resolution of 250 μm, respectively. The highly sensitive microfiber ultrasound sensor provides a competitive alternative for various applications, such as industrial non-destructive testing, biomedical ultrasound and photoacoustic imaging.