Background and Objective: Current techniques for oral diagnosis require surgical biopsy of lesions, and may fail to detect early malignant change. Non-invasive, sensitive tools providing early detection of oral cancer and a better understanding of malignant change are needed. These studies evaluated in vivo multiphoton excited fluorescence (MPM) techniques to (1) map epithelial and subepithelial changes through out oral carcinogenesis and (2) serve as an effective diagnostic modality. Study Design/Materials and Methods: In the hamster model (n ¼ 70), epithelial and subepithelial change was imaged in vivo throughout carcinogenesis. MPM-and histopathology-based diagnoses on a scale of 0 (healthy)-6 (squamous cell carcinoma [s.c.c.]) were scored by two prestandardized investigators. Results: Collagen matrix and fibers, cellular infiltrates, blood vessels, and microtumors were clearly visible. MPM agreed with the histopathology for 88.6% of diagnoses. Conclusions: In vivo MPM images provide (1) high resolution information on specific components of the carcinogenesis process (2) an excellent basis for oral diagnostics.