Although the Photo Acoustic effect was observed by Graham Bell in 1880, the first applications (gas analysis) occurred in 1970’s using the required energetic light pulses from lasers. During mid 1990’s medical imaging research begun to use Photo Acoustic effect and in vivo images were obtained in mid-2000. Since 2009, the number of patent related to Photo Acoustic Imaging (PAI) has dramatically increased. PAI machines for pre-clinical and small animal imaging have been being used in a routine way for several years. Based on its very interesting features (non-ionizing radiation, noninvasive, high depth resolution ratio, scalability, moderate price) and because it is able to deliver not only anatomical, but functional and molecular information, PAI is a very promising clinical imaging modality. It penetrates deeper into tissue than OCT (Optical Coherence Tomography) and provides a higher resolution than ultrasounds. The PAI is one of the most growing imaging modality and some innovative clinical systems are planned to be on market in 2017. Our study analyzes the different approaches such as photoacoustic computed tomography, 3D photoacoustic microscopy, multispectral photoacoustic tomography and endoscopy with the recent and tremendous technological progress over the past decade: advances in image reconstruction algorithms, laser technology, ultrasound detectors and miniaturization. We analyze which medical domains and applications are the most concerned and explain what should be the forthcoming medical system in the near future. We segment the market in four parts: Components and R&D, pre-clinical, analytics, clinical. We analyzed what should be, quantitatively and qualitatively, the PAI medical markets in each segment and its main trends. We point out the market accessibility (patents, regulations, clinical evaluations, clinical acceptance, funding). In conclusion, we explain the main market drivers and challenges to overcome and give a road map for medical approved PAI products.