The invention discloses a wearable molecular imaging navigation system comprising: a multi-spectral light transceiver configured to transmit a multi-spectral light to a detected subject in a detection region and acquire an emitting light regarding the detected subject and acquire a reflecting light regarding the detected subject; an image processor configured to receive the reflecting light and the emitting light from the multi-spectral light transceiver, execute a three-dimensional reconstruction and fusion process on the reflecting light and the emitting light to obtain a fusion image; a wireless signal processor configured to enable a wireless communication; and a wearable device, configured to receive the fusion image from the image processor via the wireless signal processor, display the fusion image and control the multi-spectral light transceiver and the image processor based on instructions received.