The direct analysis of tissue sections by MALDI mass spectrometry holds tremendous potential for biomarker discovery. This technology routinely allows many hundreds of proteins to be detected over a mass range of approximately 2000-70 000 Da while maintaining the spatial localization of the proteins detected. This technology has been applied to a wide range of tissue samples, including human glioma tissue and human lung tumor tissue. In many cases, biostatistical analyses of the resulting protein profiles revealed patterns that correlated with disease state and/or clinical endpoints. This work serves as a review of recent applications and summarizes the current state of technology.