Cerenkov luminescence imaging, which provides the advantages of short imaging time, non-toxic probe, low cost, and high sensitivity, is a hot spot in the present molecular imaging research. It makes the possibility for dual-modality of radionuclide and optical imaging achieved by single molecular probes. Cerenkov luminescence imaging has shown enormous potential in cancer diagnosis, monitoring gene expression, assessment of efficacy, guiding cancer surgery and so on. This paper introduces the recent developments of Cerenkov luminescence imaging all over the world. The optimization research of reconstruction quality and speed in Cerenkov luminescence tomography is reviewed. Meanwhile, for the limitations of Cerenkov luminescence imaging due to weak signal and poor penetrating capacity of Cerenkov light, recent developments of Cerenkov luminescence imaging optimization are also described, and the further study and improvement required in clinical translational research are discussed.