The latest research shows that the expression level of microRNA-141 can predict the number of prostate cancer cells in the human body and has become an important biomarker. In this paper, an all-carbon sandwich self-powered biosensor based on graphene and carbon cloth is constructed for the highly sensitive detection of the prostate tumor marker miRNA-141. First, gold nanoparticles modified carbon cloth is applied for substrate electrode, and bilirubin oxidase is then immobilized on it to prepare the biocathode of the biofuel cell. Then, aptamer 1 is immobilized on gold nanoparticles-modified carbon cloth as the electrode substrate. The bioconjugate is prepared by immobilizing the aptamer 2-glucose oxidase complex on gold nanoparticles/graphene. In the biofuel cell-based self-powered sensing system, when the target microRNA-141 is present, it undergoes complementary base pairing with aptamer 1 and aptamer 2, and the bioconjugates are immobilized on the anode to form the sandwich structure. The enzyme on the anode undergoes an oxidation reaction to catalyze the reduction of oxygen, and the electrochemical respond of the system increases significantly. The results show that the concentration of microRNA-141 is proportional to the open-circuit voltage value ranging from 0.0001 to 1000 pmol/L with a detection limit of 50 amol/L (S/N = 3). The method has high sensitivity and excellent selectivity and can be applied to sensitively detect tumor marker microRNA-141 in biological matrix.