Abstract: An imaging system for performing forward scanning imaging for application to therapeutic and diagnostic devises used in medical procedures. The imaging system includes forward directed optical coherence tomography (OCT), and non-retroreflected forward scanning OCT. Also interferometric imaging and ranging techniques and fluorescent, Raman, two-photon, and diffuse wave imaging can be used. The forward scanning mechanisms include a cam attached to a motor, pneumatic devices, a pivoting device, piezoelectric transducers, electrostatic driven slides for substantially transverse scanning; counter-rotating prisms, and offset lenses are used for arbitrary scanning. The imaging system of the invention is applied to hand held probes including probes integrated with surgical probes, scalpels, scissors, forceps and biopsy instruments. Hand held probes include forward scanning lasers.