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Fluorescence imaging in the second near-infrared (NIR-II) window facilitated by aggregation-induced emission luminogens (AIEgens) is an emerging research field. NIR-II AIEgens overcome limitations imposed by penetration depth and fluorescence efficiency, offering high-performance imaging with enhanced precision. Some reported NIR-II AIEgens demonstrate capabilities for fluorescence and photoacoustic bimodal imaging, and fluorescence imaging guided photothermal therapy, which not only improves diagnosis accuracy but provides an efficient theranostic platform to accelerate preclinical translation as well. This minireview summarizes recent efforts on exploiting NIR-II AIEgens with regard to molecular design strategies and bioapplications, and puts forward current challenges and promising prospects. This timely sketch should benefit the further exploitation of diverse and multifunctional NIR-II AIEgens for a wide array of applications.