This focal point article discusses the developments of biomedical Raman and infrared spectroscopy, and the recent strive towards being a recognised clinical tool for various applications. The promise of vibrational spectroscopy in the field of biomedical science, alongside the development of computational methods for spectral analysis, has driven a plethora of proof-of-concept studies which convey the potential of various spectroscopic approaches. Here we report a brief review of the literature published over the past few decades, with a focus on the current technical, clinical and economic barriers to translation, namely the limitations of many of these early studies, the lack of understanding of clinical pathways, health technology assessments, regulatory approval, clinical feasibility and funding applications. The field of biomedical vibrational spectroscopy must acknowledge and overcome these hurdles in order to achieve clinical efficacy. Current prospects have been overviewed with comment on the advised future direction of spectroscopic technologies, with the aspiration that many of these innovative approaches can ultimately reach the frontier of medical diagnostics and other clinical applications.