Recent developments in probe-based optical imaging tools such as confocal endomicroscopy have been demonstrated to be powerful techniques that can provide high-resolution in vivo morphological images at cellular and subcellular levels. Such tools may aid in real-time assessment of cancerous tissue and can also be used for intraoperative surgical guidance. However, it is a challenge to scan over a large area due to the small field-of-view and the difficulties associated with manually manipulating the probe. In this paper, a hand-held miniature scanning device for controlled, large area imaging is proposed. The device can scan target surfaces automatically. A passive linear mechanism is used to maintain good probe–tissue contacts. The results demonstrated that large area mosaics up to 31.4 mm2 can be obtained. The experimental results for ex vivo human thyroid gland tissue have shown the potential of the device for improving the prospects of intraoperative tissue identification and margin assessment.