Apparatuses and methods for scanned beam endoscopes, endoscope tips, and scanned beam imagers are disclosed. In one aspect, a scanned beam endoscope includes an endoscope tip having a scanner, an illumination optical fiber, and at least one light detection element. The illumination optical fiber may be positioned so that a beam emitted from it passes through one of the openings in the scanner. In another aspect, a scanned beam endoscope includes an endoscope tip having a handle substrate that may be attached to the scanner and include one or more vias formed therein for selectively positioning and aligning the illumination optical fiber, detection optical fibers, or both.