By virtue of the wellâdeveloped microâ and nanofabrication technologies and rapidly progressing surface functionalization strategies, siliconâbased devices have been widely recognized as a highly promising platform for the nextâgeneration labâonâaâchip bioanalytical systems with a great potential for pointâofâcare medical diagnostics. Herein, an overview of the latest advances in siliconâbased integrated optofluidic labelâfree biosensing technologies relying on the efficient interactions between the evanescent light field at the functionalized surface and specifically bound analytes is presented. Stateâofâtheâart technologies demonstrating labelâfree evanescent waveâbased biomarker detection mainly encompass three device configurations, including onâchip waveguideâbased interferometers, microring resonators, and photonicâcrystalâbased cavities. Moreover, upâtoâdate strategies for elevating the sensitivities and also simplifying the sensing processes are discussed. Emerging laboratory prototypes with advanced integration and packaging schemes incorporating automatic microfluidic components or onâchip optoelectronic devices lead to one significant step forward in real applications of decentralized diagnostics. Besides, particular attention is paid to currently commercialized labelâfree optical bioanalytical models on the market. Finally, the prospects are elaborated with several research routes toward chipâscale, lowâcost, highly sensitive, multiâfunctional, and userâfriendly bioanalytical systems benefiting to global healthcare.