Rare-earth activated upconversion nanoparticles (UCNPs) are receiving renewed attention for use in bioimaging due to their exceptional photostability and low cytotoxicity. Often, these nanoparticles are attached to plasmonic nanostructures to enhance their photoluminescence (PL) emission. However, current wet-chemistry techniques suffer from large inhomogeneity and thus low enhancement is achieved. In this paper, we report lithographically fabricated metal-insulator-metal (MIM) nanostructures that show over 1000-fold enhancement of their PL. We demonstrate the potential for bioimaging applications by dispersing the MIMs into water and imaging bladder cancer cells with them. To our knowledge, our results represent one and two orders of magnitude improvement, respectively, over the best lithographically fabricated structures and colloidal systems in the literature. The large enhancement will allow for bioimaging and therapeutics using lower particle densities or lower excitation power densities, thus increasing the sensitivity and efficacy of such procedures while decreasing potential side effects.