Nature Reviews Bioengineering, Published online: 09 June 2026; doi:10.1038/s44222-026-00458-ySpatial omics is moving from atlas-building to clinical translation, with the potential to reshape diagnosis, prognosis and therapy selection. Realizing this promise now requires scalable assays, standardized workflows, rigorous validation and regulatory-ready integration to convert spatial biology into practical tools for precision medicine.