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CDs have become one of the most promising nanomaterials in the field of fluorescent sensing, bioimaging, and cancer therapy. How to precisely regulate the photochemical properties, especially the absorption, fluorescence, phosphorescence, reactive oxygen species generation, and photothermal conversion of the CDs, is the key to developing highly efficient phototheranostics for cancer treatment. Although many studies on cancer therapy using CDs have been published, no review has focused on the regulation of photochemical properties of CDs for phototheranostic applications. In this review, we summarized the strategies such as the selection of suitable carbon source, heteroatomic doping, optimum reaction conditions, surface modification, and assembly strategy to efficiently regulate the photochemical properties of the CDs to meet the requirements of different practical applications. 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