Monitoring the deformations of immersed tunnels is important during the entire tunnel service life to assess the structural integrity of the tunnel. Conventional joint deformation monitoring is based on manual levelling measurements and normally occurs only at multi-year intervals, which does not allow to capture short term deformation behavior. In this study a new joint monitoring system using distributed optical fiber sensors (DOFS) is developed. A special sensor layout is designed that allows simultaneous measurements of both horizontal joint opening and vertical uneven settlement of the immersion and dilation joints. For this sensor scheme the transfer relation from fiber strain to joint deformation is derived and verified by in-lab experiments. The sensor system proves to be able to detect sub-millimeter joint deformations, indicating a more than sufficient accuracy for structural monitoring of immersed tunnel joints. Subsequently, the First Heinenoordtunnel in the Netherlands is instrumented using this distributed optical fiber sensing system, in order to obtain additional data for both long-term and short-term assessment of its structural condition.