<p>Dopamine deficiency is a non-vascular neurodegenerative disorder that involves the destruction of dopaminergic neurons, aggregation of α-synuclein, mitochondrial dysfunction, oxidative stress, and chronic neuroinflammation. The prolonged prodromal period, high clinical heterogeneity, and absence of disease-modifying treatment pose great difficulty in diagnosing and treating dopamine deficiency, especially in its early identification and successful brain-specific therapy. A potential solution to these unmet needs is neurotheranostics, which combines diagnostic and therapeutic capabilities on a single platform. The potential of silicon quantum dots (SiQDs) has made them a promising nanomaterial for applications in dopamine deficiency, thanks to their outstanding biocompatibility, optical properties, and flexible surface chemistry. This review critically and comprehensively analyzes the use of silicon quantum dots as neurotheranostic nanomaterials for the management of dopamine deficiency. We have discussed the structural, optical, and electronic characteristics of SiQDs that enable imaging, as well as their biocompatibility benefits compared to conventional heavy-metal-based quantum dots. Synthesis and engineering approaches, such as size control, doping, photoluminescence control, and surface functionalization, for targeted delivery to the central nervous system (CNS) and heart function are discussed. The processes controlling the blood-brain barrier transport, neuronal targeting, and intracellular transport were examined. 'SiQDs' potential as a therapeutic agent was tested across the main domains of dopamine deficiency pathogenesis, including protection of dopaminergic neurons, aggregation of α-synuclein, neuroinflammation, and oxidative stress. Diagnostic and multimodal imaging, preclinical pharmacological behavior, safety concerns, and translational issues of these agents are critically evaluated. In short, this article outlines the current state of SiQD-based neurotheranostics and the key design principles and research directions needed to further develop the technology's clinical use for the treatment of dopamine deficiency.Dopamine deficiency is a progressive neurodegenerative condition characterized by dopaminergic neuron degeneration, α-synuclein aggregation, mitochondrial dysfunction, oxidative stress, and chronic neuroinflammation. The extended prodromal phase, significant clinical heterogeneity, and lack of disease-modifying therapies present substantial challenges in the diagnosis and treatment of dopamine deficiency, particularly in early detection and effective brain-targeted interventions. Neurotheranostics, which integrates diagnostic and therapeutic functions on a single platform, offers a promising approach to address these unmet needs. Silicon quantum dots (SiQDs) have emerged as a promising class of nanomaterials for applications related to dopamine deficiency owing to their excellent biocompatibility, tunable optical properties, and versatile surface chemistry. This review provides a detailed and critical examination of the application of silicon quantum dots as neurotheranostic nanomaterials for the management of dopamine deficiency. We explored the structural, optical, and electronic properties of SiQDs that facilitate imaging and their biocompatibility advantages over traditional heavy metal-based quantum dots. Key synthesis and engineering strategies are discussed, including size control, doping, photoluminescence tuning, and surface functionalization for targeted delivery to the central nervous system (CNS) and heart function. The mechanisms governing blood-brain barrier transport, neuronal targeting, and intracellular transport were analyzed. The therapeutic potential of SiQDs was evaluated in key areas associated with dopamine deficiency pathogenesis, such as dopaminergic neuron protection, α-synuclein aggregation, neuroinflammation, and oxidative stress. The diagnostic and multimodal imaging capabilities, preclinical pharmacological behavior, safety considerations, and translational challenges of these agents are critically assessed. In summary, this article delineates the current status of SiQD-based neurotheranostics and outlines the primary design principles and research directions necessary to advance their clinical application in addressing dopamine deficiency.</p> Graphical abstract <p></p>