Optofluidic, as an emerging technology that combines photons and microfluidics, has become a powerful, intelligent, and universal sensing platform in the field of bio-chemical sensing. Optical fiber optofluidic (OFOF), as a branch of optofluidic technology, has stimulated a host of remarkable achievements in the field of bio-chemical sensing due to its superiority of compact structure, immunity to electromagnetic interference, low sample consumption, high sensitivity, and real-time dynamic response. In this paper, an overview of OFOF bio-chemical sensors is presented. The OFOF system architectures are introduced and some advanced functional materials and coating technologies that can be utilized in the OFOF sensing platform to achieve high-performance biochemical sensing are summarized. Research progress and current status of OFOF bio-chemical sensors based on various sensing mechanisms are summarized and analyzed, with emphases on their sensing principles, sensing structures, sensing applications, advantages, and disadvantages. Lastly, the existing challenges and future development trends of OFOF biochemical sensors are briefly discussed.