This paper reviews the evolution of optical imaging in diagnostic radiology and examines recent progress. Although the idea has been around for many decades, interest in the development of an effective method has never been so great. Optical imaging presents several potential advantages over existing radiological techniques. First, the radiation is non-ionizing and therefore reasonable doses can be repeatedly employed without harm to the patient. Second, optical methods offer the potential to differentiate between soft tissues with different optical absorption or scatter, but which are indistinguishable using other modalities. And third, specific absorption by natural chromophores (such as haemoglobin) allows functional information to be obtained. Principal clinical applications include a means of detecting breast disease and a cerebral imaging modality for mapping oxygenation and haemodynamics in the brain of newborn infants or cortical functional activity in adults. Past attempts to image tissues with light have been severely restricted by the overwhelming scatter which occurs when optical radiation spreads through tissue: however, recent innovations in technology have suggested once again that it may be a practical possibility.