Cycling hypoxia has been recognized as a typical characteristic of a wide range of hepatic diseases, and its real time imaging is of necessity for better understanding of its biological functions. However, effective optical probes for reversible hypoxia detection in liver are lacking. Herein, we designed a near-infrared fluorescence/photoacoustic (NIRF/PA) probe, AzoCys-CF3, that displayed a highly selective and reversible off-on switching of both NIRF and PA signals in response to normoxia-hypoxia cycles. AzoCys-CF3 could not only monitor the acute hypoxia status during the hepatic ischemia-reperfusion process, but also track the extent of chronic hepatic hypoxia in NAFLD model mice. Antioxidant drug screening by AzoCys-CF3 demonstrated that the hepatoprotective drug orlistat significantly attenuated hypoxia in the livers of NAFLD mice. This work provided a reliable NIRF/PA imaging agent for in vivo monitoring of cycling hypoxia, showing potential application in screening drugs for hepatic diseases.