We proposed and investigated an ultrahigh sensitivity terahertz (THz) refractive index sensor based on four-inscribed hole defect photonic crystal structure. Due to the formation of resonant modes, the sensing properties can be obtained by shifting the sharp resonance in the transmission spectrum as changing of the analyte refractive index. In addition, the influence of structure parameters on the sensing performance is explored and demonstrated numerically. The numerical results illustrate that the Q-factor and figure of merit reach 323.71 and 167.188 can be obtained under the optimized structural parameters. In particular, an ultrahigh sensitivity of 198.8 μm/RIU can be realized in the frequency range of 0.777–0.779 THz. The proposed sensor may find significant applications in biochemical sensing systems. © 2023 Wiley Periodicals LLC.