MicroRNAs (miRNAs) are emerging as essential liquid biopsy markers for early cancer detection. Currently, the clinical applications of miRNAs are lagging behind due to their high sequence similarity and rarity. Herein, we propose biointerference-free, target-triggered core-satellite nanocomposites for ultrasensitive surface-enhanced Raman spectroscopy (SERS) detection of lung cancer-related miRNA-21. Through the hybridization-based recognition effect, we observe an enormous SERS signal enhancement caused by miRNA-21-triggered assembly of core-satellite nanocomposites. This enables the sensitive detection of miRNA-21 down to the 0.1 fM level in a linear range of 10 fM to 1 nM. The use of a biointerference-free reporter further allows quantitative and direct detection of miRNA-21 from complex plasma samples, without RNA pre-extraction. As a proof of principle, we measure the level of plasma miRNA-21 in 20 lung cancer patients and 10 healthy participants. Significantly higher levels of miRNA-21 are determined in lung cancer patients than in healthy participants, with clear lower expression in stage I (n = 10) than in stage III-IV (n = 10) lung cancer patients. We, therefore, believe that this proposed strategy will have high clinical potential for sensitive quantification of miRNA markers in liquid biopsy samples and act as a complementary method for the early detection of lung cancer.