Lensless fiber endomicroscopy is an emerging technology that leverages holographic detection and wavefront correction to enable high-resolution, minimally invasive optical imaging and targeted light delivery. This perspective reviews recent breakthroughs in this field, highlighting its potential applications in biomedicine, such as brain surgery, tumor classification, neuroimaging, and optogenetic stimulation. The technology uses flexible ultra-thin fibers to navigate through small openings or delicate tissues, reducing tissue damage compared to conventional endoscopes. Key advancements include the use of multicore fibers (MCFs) and multimode fibers (MMFs) for high-resolution imaging, wavefront shaping for precise light delivery, and deep neural networks for image processing. Despite challenges such as reduced detection aperture and complex light propagation, lensless fiber endomicroscopy offers significant opportunities for early disease detection, targeted biopsies, and real-time monitoring of treatment responses. The article emphasizes the importance of balancing innovation with practical implementation to bridge the gap between laboratory-scale innovations and real-world medical applications.Lensless fiber endomicroscopy is an emerging technology that leverages holographic detection and wavefront correction to enable high-resolution, minimally invasive optical imaging and targeted light delivery. This perspective reviews recent breakthroughs in this field, highlighting its potential applications in biomedicine, such as brain surgery, tumor classification, neuroimaging, and optogenetic stimulation. The technology uses flexible ultra-thin fibers to navigate through small openings or delicate tissues, reducing tissue damage compared to conventional endoscopes. Key advancements include the use of multicore fibers (MCFs) and multimode fibers (MMFs) for high-resolution imaging, wavefront shaping for precise light delivery, and deep neural networks for image processing. Despite challenges such as reduced detection aperture and complex light propagation, lensless fiber endomicroscopy offers significant opportunities for early disease detection, targeted biopsies, and real-time monitoring of treatment responses. The article emphasizes the importance of balancing innovation with practical implementation to bridge the gap between laboratory-scale innovations and real-world medical applications.