It is well known that elevated homocysteine (HcySH) values can lead to a wide range of diseases. Quantifying HcySH can be an aid in early diagnosis and treatment of related illnesses. Consequently, it is very significant to develop a sensitive detection technology for exact monitoring of HcySH. Based on the excellent affinity of Au NPs with the -SH group in HcySH and the excellent conductivity of cMWCNTs, a novel electrochemical sensor (Au NPs/cMWCNTs/GCE) was constructed to detect HcySH in this paper. The sensor not only can effectively improve the specificity of HcySH detection, but also has the wide linear range and low detection limit (2.89 × 10−8 M, S/N = 3). What’s more, the homocysteine contents of a variety of serum samples were directly detected by the constructed sensor for the first time, and the recovery rate was satisfactory. In conclusion, the research provided an effective method to achieve the rapid, reliable and ultrasensitive determination of HcySH, which has important applications in biomedical analysis and clinical diagnosis.