Thromboembolic diseases pose a significant threat to global morbidity and mortality. Challenges in thrombus imaging and therapy exist in targeting accumulation and controlled activation of therapeutic and diagnostic agents at the thrombus site. To address this, yolk-shell-structured nanoparticles (NPs) are developed that integrate endogenous shear stress-triggered contact-electrification luminescence with synergized tribocatalysis and photodynamic therapy (PDT) for thrombus theranostics. Specifically, fluorinated silica (SiF) layers and Mn-doped lutetium/aluminum/garnet (MnL) are sequentially deposited onto SiF yolks, followed by etching the SiF interlayer and surface grafting of chlorin e6 (Ce6) and Cys-Arg-Glu-Lys-Ala peptides, yielding SiF@MnL/C6-C NPs. Shear stress activates continuous collisions between yolks and shells to generate triboelectric charges that trigger interfacial electron transfer for tribocatalysis and electron transition in MnL for triboluminescence. The endogenous luminescence excites Ce6 for on-site thrombus diagnosis and the simultaneous PDT synergizes tribocatalysis to amplify reactive oxygen species (ROS) generation for thrombolysis. Alkaline etching optimizes surface roughness and greatly enhances the triboelectric potential to boost luminous intensity and ROS generation, allowing for real-time embolism diagnosis, effective thrombolysis, and complete blood flow restoration while minimizing bleeding risk and systemic toxicity. This study presents a streamlined theranostic strategy leveraging endogenous shear stress-adaptive triboluminescence imaging combined with tribocatalysis-PDT synergy for targeted thrombolysis.