Mass spectrometry imaging (MSI) is a technique used in mass spectrometry to visualize the spatial distribution of molecules, as biomarkers, metabolites, peptides or proteins by their molecular masses. After collecting a mass spectrum at one spot, the sample is moved to reach another region, and so on, until the entire sample is scanned. By choosing a peak in the resulting spectra that corresponds to the compound of interest, the MS data is used to map its distribution across the sample. This results in pictures of the spatially resolved distribution of a compound pixel by pixel. Each data set contains a veritable gallery of pictures because any peak in each spectrum can be spatially mapped. Despite the fact that MSI has been generally considered a qualitative method, the signal generated by this technique is proportional to the relative abundance of the analyte. Therefore, quantification is possible, when its challenges are overcome. Although widely used traditional methodologies like radiochemistry and immunohistochemistry achieve the same goal as MSI, they are limited in their abilities to analyze multiple samples at once, and can prove to be lacking if researchers do not have prior knowledge of the samples being studied. Most common ionization technologies in the field of MSI are DESI imaging, MALDI imaging and secondary ion mass spectrometry imaging (SIMS imaging). History More than 50 years ago, MSI was introduced using secondary ion mass spectrometry (SIMS) to study semiconductor surfaces by Castaing and Slodzian. However, it was the pioneering work of Richard Caprioli and colleagues in the late 1990s, demonstrating how matrix-assisted laser desorption/ionization (MALDI) could be applied to visualize large biomolecules (as proteins and lipids) in cells and tissue to reveal the function of these molecules and how function is changed by diseases like cancer, which led to the widespread use of MSI. Nowadays, different ionization techniques have been used, including SIMS, MALDI and desorption electrospray ionization (DESI), as well as other technologies. Still, MALDI is the current dominant technology with regard to clinical and biological applications of MSI. Operation principle The MSI is based on the spatial distribution of the sample. Therefore, the operation principle depends on the technique that is used to obtain the spatial information. The two techniques used in MSI are: microprobe and microscope. Microprobe This technique is performed using a focused ionization beam to analyze a specific region of the sample by generating a mass spectrum. The mass