Low density lipoproteins (LDL) have long been recognized as a potential delivery system for exogenous agents. Imaging agents or drugs can be attached to LDL through surface loading, protein loading or core loading methods. The LDL delivery system has received considerable attention particularly among cancer biologists as it was observed that numerous cancers over-express the low density lipoprotein receptor (LDLR). In this paper we investigate the utility of LDL to transport optical imaging contrast agents for caner detection. The method of loading fluorophores into the core of LDL is attractive as it behaves like an activatable contrast agent. Surface and protein labeled methods also prove to be effective strategies for tracing LDL nanoparticle activity. The strengths and limitations of the LDL carrier system are discussed and novel approaches for imaging cancer with LDL nanoparticles are highlighted.