Tissue visualization catheters with imaging systems integrated within the imaging catheter system are described. The tissue-imaging apparatus relates to devices and/or methods to provide visualization of tissue regions within a body lumen such as a heart, which is filled with blood flowing dynamically therethrough. High-resolution images can be obtained by miniaturizing and integrating solid state cameras into the tissue visualization catheter in a number of different off-axis configurations. One or more light sources can also be optionally integrated with the solid state imagers to illuminate the tissue from different angles.