Optical Coherence Tomography (OCT) is well-suited to study in vivo dynamics of blood circulation and lymphatic flow because of the technique’s combination of rapid image acquisition, micron spatial resolution, and penetration depth in turbid tissues. However, OCT has been historically constrained by a dearth of contrast agents that are readily distinguished from the strong scattering intrinsic to biological tissues. In this study, we demonstrate large gold nanorods (LGNRs) as optimized contrast agents for OCT. LGNRs produce 32-fold greater backscattering than GNRs previously tested for contrast-enhanced OCT. Furthermore, LGNRs exhibit 110-fold stronger spectral signal than conventional GNRs when coupled with custom spectral detection algorithms. This signal enhancement enables picomolar OCT detection sensitivity in vivo and single-particle detection against optically-clear backgrounds. Moreover, the ability to synthesize LGNRs with tunable spectral peaks provides a viable platform for multiplexed imaging studies. To explore the advantages of LGNRs as OCT contrast agents, we implemented them for noninvasive 3D imaging of tumor blood supply and active lymphatic drainage in mice. Spectral detection of LGNRs enabled 100% improvement in imaging depth for detecting microvasculature (vessels ∼ 20 μm in diameter) in U87MG glioblastoma xenografts in mice pinnae. We also demonstrated our approach’s ability to map the spatial dependence of lymph drainage and flow directionality within lymphatic capillaries. Using LGNRs with distinct spectra, we further identified the functional states of individual lymphatic valves in vivo. Thus, this approach provides a powerful new platform for functional imaging that may be extended for future molecular imaging studies with OCT.