Herein, a smart competitive-type photoelectrochemical (PEC) sensor based on an antigen-down (Ag-down) format for procalcitonin (PCT) detection is proposed. A fullerene sensitized flower-like Sn3O4 nano-structure is used as the photoactive platform, and FeS2 is labeled on the secondary antibody as a signal adjusting element. The sensor exhibits excellent sensitivity and great stability.