Precision imaging is a collection of image sensing techniques involving ultra-high sensitivity, time accuracy, and dynamic range, as well as ultra-low noise. In fact, imaging biological processes often requires sub-milli-lux sensitivity to detect tiny levels of bioluminescence or time-correlated techniques to precisely evaluate the decay time of a fluorophore. In this paper we explore the impact precision imaging will likely have on bioimaging and medical imaging. We also describe VLSI techniques that could enable precision imaging devices in the short and medium term and their relevance to the field of imaging as a whole.