The systems and methods described herein provide for a forward looking guidewire having a reduced radial cross-section for increased maneuverability and use of the guidewire within more narrow vasculature. The guidewire can include an elongate tubular member having a distal region, proximal region and inner lumen and a forward looking imaging device coupled with the distal end of the guidewire. The distal region of the guidewire can be relatively more flexible than the proximal region. The guidewire can also include a second, side looking imaging device, which can be coupled around a longitudinal portion of the guidewire in the radial or proximal regions.