Precise evaluation of telomerase activity is highly crucial for early cancer diagnosis. In this study, a sensitive catalytic hairpin assembly-dynamic light scattering (CHA-DLS) assay for telomerase activity detection is developed by using the diameter change of gold nanoparticle (AuNP) probes. The telomerase substrate primer can be extended in the presence of telomerase, producing a telomerase extension product (TEP) with telomeric repeat units (TTAGGG)n at its 3'-end. The TEP can specifically trigger the CHA process and form tremendous AuNPs-H1/H2 nanostructures, resulting in a significant increase in the diameter measured by DLS. Telomerase activity from different cancer cell lines (MCF-7, Huh7, and 5637) was detected using the proposed strategy, the diameter of AuNP probes increased with the number of cancer cells, and this method can accurately detect telomerase activity down to 6 MCF-7 cells, 10 Huh7 cells, and three 5637 cells. Moreover, the CHA-DLS biosensor was successfully applied in urine specimens from healthy individuals and different cancer patients, which can distinguish bladder cancer patients from healthy people and other cancer patients, indicating that the noninvasive method has a great potential for application in early diagnosis of bladder cancer.