Early and accessible diagnostics are important elements to reducing the negative side-effects of untreated disease. One key advancement in diagnostic monitoring is through the development of highly sensitive sensors that have the capability to detect lower concentrations, while still remaining accessible for point-of-care use. This dissertation characterizes electrochemical sensing platforms that are enhanced by convection and by 3D electrodes made from high surface area, vertically aligned carbon nanotubes (VACNTs). Free-standing VACNTs were patterned into microchannel arrays for flow-through amperometric sensing. Convective mass transfer enhancement was shown to improve sensor performance in amperometric sensing through the use of high surface area to fluid volume structures and concentration boundary layer confinement. Through-flow sensing of hydrogen peroxide produced drastically higher signals than stirred sensing, with over 90% of the hydrogen peroxide being oxidized as it passed through the channels. Non-enzymatic sensing of glucose was achieved by chemical reaction of glucose with methyl viologen to produce on average 3.4 electrons per glucose molecule, significantly higher than that obtained with enzymatic sensing with glucose oxidase. A scaled down sensor enabled detection from 200 μL of glucose by flow injection analysis with a limit of detection of 360 nM and a linear sensing range up to at least 150 μM glucose. Such sensing range offers the potential to measure glucose levels found in saliva. This work demonstrates the utility of high aspect ratio electrodes made of VACNTs. Convection and surface area are shown to enhance the sensitivity of flow-through VACNT amperometric sensors by effectively utilizing the available analyte to increase the measured current density. Advances in nanomaterials, combined with electrochemical impedance spectroscopy, have allowed impedimetric biosensors to have high sensitivity while remaining label-free, pushing towards enabling portable diagnosis at the point-of-care. Porous, 3D VACNT electrodes for impedance-based biosensing were fabricated with different electrode height, gap width, and configuration. Sensitivity was characterized by functionalizing the representative protein streptavidin onto VACNT electrodes for detection of biotin. Tall, closely-spaced VACNT interdigitated electrodes are shown to have the highest electroactive surface area (15x the 2D geometric area) and the highest sensitivity, allowing for a 1 ng/mL limit of detection. Aspect ratio and surface area are shown to be important factors in determining the sensitivity of 3D VACNT interdigitated electrodes for impedimetric sensing of biomolecules bound to electrode surfaces. Although this biosensing platform is shown with streptavidin and biotin, it could be extended to other proteins, antibodies, viruses, and bacteria.