Cancer is the leading cause of death worldwide, with millions of new cases and fatalities reported each year. Early detection plays a critical role in improving treatment outcomes and survival rates, as it allows for timely intervention and more effective therapies. Traditional diagnostic methods often face limitations in sensitivity, specificity, and the ability to detect tumors at an early stage. Therefore, there is a growing need for advanced diagnostic tools that can offer higher precision and earlier detection of cancer. In this regard, Near-Infrared (NIR) imaging has emerged as a promising technique, offering non-invasive, real-time, and high-resolution imaging capabilities for tumor visualization. Small organic molecules-based NIR agents have recently garnered attention in the field of cancer diagnostics due to their superior biocompatibility, tunable properties, and ability to penetrate deeper into tissues. These agents, including various organic fluorophores, that are designed to enhance the sensitivity and specificity of cancer imaging, enabling the detection of smaller tumors that are otherwise challenging to identify. This review aims to provide an overview of the latest advancements (2020–2025) in small organic molecules-based NIR agents for various cancer diagnosis, focusing on their development, applications, and potential for clinical use. By examining key innovations in this area, this article seeks to highlight the impact of small organic molecules-based NIR agents on the future of cancer theranostics.