For decades, macroscopic and microscopic analysis of human tissue specimens by pathologists has been the basis for disease classification. In recent years, there has been an increasingly better understanding of molecular alterations underlying the pathogenesis of cancers as well as the establishment and integration of novel molecular analyses into a histomorphological-based workflow. This has dramatically extended the possibilities of diagnostic pathology - from its descriptive role to a clinical advisory role on cancer classification including prognostic and predictive molecular pathological information. This review will focus on the recent developments of molecular pathological techniques and the current tools and applications of predictive pathology in view of targeted therapies in solid cancers.