Over the past decade, NIRF imaging has emerged as an indispensable tool in biomedical research and clinical practice. Its integration into oncological surgery, in particular, has revolutionized intraoperative decision-making, improving patient engagement and treatment adherence through enhanced visualization. This chapter examines the transformative potential of NIRF imaging-guided surgical systems, emphasizing advancements in robot-assisted precision surgery, targeted fluorescence-guided biopsy, and post-resection specimen assessment. Additionally, it explores synergistic integrations with cutting-edge technologies such as VR for immersive surgical planning and AI for real-time image interpretation. Finally, the chapter highlights the role of NIRF imaging in evaluating neoadjuvant therapy outcomes, underscoring its versatility in optimizing personalized cancer care.