Abstract: With the development of optical molecular imaging technology and target optical molecular, the guided surgery by optical molecular imaging will be the third generation surgery after open surgery and minimally invasive surgery. In this paper, fluorochrorne and fluorescence diagnosis, fluorescence imaging and optical molecular imaging, optical molecular imaging and optical molecular imaging equipment are discussed in concept. It is clearly pointed out that optical molecular imaging surgery will be a new cutting edge of precision surgery. Optical molecular imaging surgery is composed of target optical molecular agent, optical molecular imaging equipment, and clinical diagnosis and treatment technology.