The number of in vitro, ex vivo, and in vivo studies on porous silicon (PSi) nanoparticles for biomedical applications has increased extensively over the last decade. The focus of the reports has been on the carrier properties of PSi concerning the therapeutic aspect due to several beneficial nanovector characteristics including high payload capacity, biocompatibility, and versatile surface chemistry. Recently, increasing attention has been paid to the diagnostic aspects of PSi, which is typically attributed to the biotraceability of the nanovector. Also, PSi has been studied as a contrast agent. When both these aspects, therapy and diagnosis, are integrated into one nanovector, we can discuss a real nanotheranostics approach. Herein, we review the recent progress developing PSi for various imaging modalities, specifically focusing on optical imaging, magnetic resonance imaging, and nuclear medicine imaging. Furthermore, we summarized the knowledge gaps that must be covered before applying PSi in clinical imaging, highlighting future research trends.