To understand fully an organism in health and disease we must assemble a genuinely comprehensive model of the organism, including metabolic profiles for both large and small molecules together with their interaction profiles. This chapter outlines how particular applications of imaging technologies are revolutionising such a 'systems' understanding of biology and medicine. The combination of such 'Omics' approaches (e.g. proteomics and genomics) with imaging science will lead to a much more comprehensive description of biological systems, allowing us to pose new questions about the nature of biology and offering new ways for the practice of medicine. Label-free approaches using plasmonic microscopy are described, and Alzheimer's disease is used as an exemplar of how disease diagnostics may be enhanced by application of such approaches and technologies. Some advances of conventional plasmonic imaging techniques, based on using localised plasmons, that seem likely to yield greater sensitivity and functionality are proposed. © 2014 Woodhead Publishing Limited All rights reserved.