This review is concerned with nanoscale effects in highly transparent dielectric photonic structures fabricated from optical fibers. In contrast to those in plasmonics, these structures do not contain metal particles, wires, or films with nanoscale dimensions. Nevertheless, a nanoscale perturbation of the fiber radius can significantly alter their performance. This paper consists of three parts. The first part considers propagation of light in thin optical fibers (microfibers) having the radius of the order of 100 nanometers to 1 micron. The fundamental mode propagating along a microfiber has an evanescent field which may be strongly expanded into the external area. Then, the cross-sectional dimensions of the mode and transmission losses are very sensitive to small variations of the microfiber radius. Under certain conditions, a change of just a few nanometers in the microfiber radius can significantly affect its transmission characteristics and, in particular, lead to the transition from the waveguiding to non-waveguiding regime. The second part of the review considers slow propagation of whispering gallery modes in fibers having the radius of the order of 10–100 microns. The propagation of these modes along the fiber axis is so slow that they can be governed by extremely small nanoscale changes of the optical fiber radius. This phenomenon is exploited in SNAP (surface nanoscale axial photonics), a new platform for fabrication of miniature super-low-loss photonic integrated circuits with unprecedented sub-angstrom precision. The SNAP theory and applications are overviewed. The third part of this review describes methods of characterization of the radius variation of microfibers and regular optical fibers with sub-nanometer precision.