Dark field light scattering imaging is a kind of scattered light microscope imaging technique that produces a dark background by obliquely illuminating the sample with incident light. It has the characteristics of low background signal and high signal-to-noise ratio, but it is difficult to identify material composition and internal component. Surface enhanced Raman scattering spectrum is a fingerprint spectrum of molecular vibrations with the characteristics of high sensitivity and non-destructive testing. Noble metal nanoparticles are usually used as the substrates for signal enhancement, but there is no clear standard for the selection of Raman "hot spot" area of micro-measurement, resulting in large fluctuations in Raman signals. The combination of dark field light scattering imaging and surface enhanced Raman scattering allows not only high-resolution microscopic localization of Raman "hot spot" region, but also highly sensitive detection of components in dark field imaging, and high-resolution detection of sample morphology and components can be realized simultaneously in time and space. In this review, the advantages, principles, and applications of dark field light scattering imaging coupled with surface enhanced Raman scattering are summarized, and the recent applications in biochemical molecular detection, cell detection, chemical reaction dynamic monitoring, and other aspects are introduced, which provide new ways for biomedical detections.