Solid-state nanoapertures (nanometer sized holes within a membrane) allow for the interrogation of single molecules by probing them within their nanoscale volume through which molecules pass in a single-file manner. Molecules are probed using two main techniques: ionic sensing where a salt solution and applied voltage is used to produce an ionic current through the nanopore, and optical sensing through a shift in the resonance wavelength of the plasmonic nanoaperture. Here, we briefly review the basic principles, applications, and challenges in sensing with solid-state nanoapertures, as well as some strategies for further improvements. We compare the complimentary features of the two approaches and highlight recent attempts to combine them into new sensing platforms.