Diagnostic potential of autofluorescence spectroscopy and imaging for early detection of precancerous and malignant lesions has been actively investigated for almost twenty years. Fluorescence diagnosis based on excitation of the fluorescence of endogenous fluorophores can detect human neoplasia with high sensitivity and specificity. The autofluorescence methods may provide an important auxiliary tool assisting and facilitating the correct diagnosis but their diagnostic merit still has to be proven in properly performed randomized studies.