Lung cancer could be developed through a series of morphological changes from dysplasia to carcinoma in situ and then invasive cancer. However, precancerous lesions are generally a few cell layers thick and are detected only by chance. Autofluorescence bronchoscopy(AFB) is one of the newly developed diagnostic tools to detect the pre-cancerous lesions m the bronchial tissue. Several studies have shown that AFB improved the rate of detection of cancer and dysplastic lesions of the airway, especially those in intraepithelial stage. However, there were high rates of false positive with AFB, and it is also important to develop non-biopsy methods because of lack of accurate information of variable course of preneoplastic lesions regarding progression. So, many other technologies were developed, such as narrow band imaging(NBI), endobronchoscopic ultrasound, optical coherence tomography, and confocal fluorescence microendoscopy. Among the new machines, NBI is a new optical technology that can clearly visualize the microvascular structure m the mucosal layer. NBI seems to increase specificity without compromising sensitivity. In the future such techniques would make it possible to precisely study in detail the natural history of the premalignant epithelium.