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A breath sensor for real-time measurement of human exhaled carbon monoxide is reported. This breath sensor is based on a novel photoacoustic heterodyne gas sensing technique, which combines the conventional photoacoustic spectroscopy with the beat-frequency detection algorithm, thus offering a fast response time and a convenient optical alignment, as well as eliminating the needs for frequency calibration and wavelength locking. The principle of photoacoustic heterodyne gas sensing was explained in detail. The performance of the photoacoustic heterodyne breath sensor was evaluated in terms of minimum detection limit, response time, and linearity. The exhaled carbon monoxide levels of eight volunteers were measured and the results demonstrate the reliability and feasibility of this breath sensor.