Using a regular CMOS sensor as a template, we are able to fabricate a simple but highly effective superhydrophobic SERS substrate. Specifically, we decorated the microlens layer of the sensor with 7 μm polystyrene beads to obtain a PDMS patterned replica. The process resulted in a uniform pattern of voids in the PDMS (denoted nanobowls) that are intercalated with a few larger voids (denoted here microbowls). The voids act as superhydrophobic substrates with analyte concentration capabilities in bigger bowl-like structures. Silver nanoparticles were directly grown on the patterned PDMS substrate inside both the nano- and microbowls, and serve as strong electromagnetic field enhancers for the SERS substrate. After systematic characterization of the fabricated SERS substrate by atomic force microscopy and scanning electron microscopy, we demonstrated its SERS performance using 4-aminothiophenol as a reporter molecule. Finally, we employed this innovative substrate to concentrate and analyze extracellular vesicles (EVs) isolated from an MC65 neural cell line in an ultralow sample volume. This substrate can be further exploited for the investigation of various EV biomarkers for early diagnosis of different diseases using liquid biopsy.