Sonodynamic therapy eliminates cancer cells with reactive oxygen species (ROS) triggered by ultrasound whose energy is spatiotemporally controllable, is safe to human tissues and organs, and penetrates deeply through tissues. Its application, however, is hindered by the scarcity of sonodynamic sensitizers. We herein demonstrate piezoelectric materials as a new source of sonodynamic sensitizers, using few-layer black phosphorus (BP) nanosheet as a model. BP nanosheet exhibited ultrasound-excited cytotoxicity to cancer cells via ROS generation, thereby suppressing tumor growth and metastasis without causing off-target toxicity in tumor-bearing mouse models. The ultrasonic wave introduces mechanical strain to the BP nanosheet, leading to piezoelectric polarization which shifts the conduction band of BP more negative than O2/·O2- while its valence band more positive than H2O/·OH, thereby accelerating the ROS production. This work identifies a new mechanism for discovering sonodynamic sensitizers and suggests BP nanosheet as an excellent sensitizer for tumor sonodynamic therapy.