The greatest challenges for surgical management of cancer are precisely locating lesions and clearly defining the margins between tumors and normal tissues. This is confounded by the characteristics of the tissue where the tumor is located as well as its propensity to form irregular boundaries with healthy tissues. To address these issues, molecularly targeted optical contrast agents have been developed to define margins in real-time during surgery 1,2 . However, selectivity of a contrast agent is often limited by expression of a target enzyme or receptor in both tumor and healthy tissues. Here we introduce a concept of multivariate 'AND-gate' optical imaging probes that require sequential processing by multiple tumor-specific enzymes to produce a fluorescent signal. This results in dramatically improved specificity as well as overall enhanced sensitivity. This general approach has the potential to be broadly applied to selectively target complex patterns of enzyme activities in diverse disease tissues for detection, treatment and therapy response monitoring. AND-Gate probes. Thanks to Michael P. Luciano and Martin J. Schnermann at the National Cancer Institute for supplying the FNIR-Tag-OSu used to synthesize the AND-Gate-FNIR probe. Thanks to the Peter Santa Maria Lab for using their SpectraM2 plate reader. AUTHOR CONTRIBUTIONS M.B. and J.C.W conceived of the AND-Gate probe concept and designed all experiments. J.C.W synthesized all AND-Gate probes, conducted the fluorogenic substrate assays, live and fixed cell fluorescent microscopy experiments, and mouse model experiments. J.C.W and M.B. wrote the text of the paper and constructed the figures with input from J.J.Y., M.T., and J.J.Y helped perform live and ex vivo imaging during the 4T1 cancer mouse model experiment including dissection of the mice. M.T. aided in the immunohistochemical analysis of 4T1 tumors. A.A, A.K., and J.S. assisted with the robotic surgery. S.R. assisted in the colorectal cancer mouse model. K.M.C. evaluated H&E sections for the colorectal and 4T1 breast cancer mouse models.