Systems for confocal Raman spectroscopy of points of interest or regions of interest with concurrent imaging are disclosed. The imaging may be used for real time selection of points of interest or regions of interest for Raman spectroscopy and to monitor for unwanted motions of a sample while Raman spectra are acquired. Disclosed embodiments apply Reflectance confocal microscopy (RCM) in a confocal Raman spectroscopy system. A single laser may be used as a light source for both RCM and micro-Raman spectroscopy. A Faraday optical isolator may be applied to extract RCM signals for imaging Systems as described herein have example application for ex vivo sample and in vivo skin measurement.