Coating biological membranes onto biomimetic nanocarriers improves biocompatibility, prolongs circulation, and enhances targeted delivery for cancer precision medicine. To better understand the biodistribution profiles of these biomimetic nanosystems, molecular imaging techniques, including optical imaging, radionuclide imaging, magnetic resonance imaging, and ultrasound imaging, have been widely employed for in vivo tracking and dynamic imaging. Here in this review, we delve into the profound role of these imaging modalities in visualizing changes in the tumor microenvironment, particularly in monitoring oxygen consumption and immune response dynamics, highlighting their potential to improve cancer therapies. We also briefly discuss current applications of molecular imaging in synergistic cancer therapies and future perspectives. Finally, we offer insights into the potential of integrating biomimetic nanomedicine with molecular imaging for clinical translation.