Pressure ulcers have been identified as a public health concern by the US government through the Healthy People 2010 initiative and the National Quality Forum (NQF). Currently, no tools are available to assist clinicians in erythema, i.e. the early stage pressure ulcer detection. The results from our previous research (supported by NIH grant) indicate that erythema in different skin tones can be identified using a set of wavelengths 540, 577, 650 and 970nm. This paper will report our recent work which is developing a handheld, point-of-care, clinicallyviable and affordable, real time multispectral imager to detect erythema in persons with darkly pigmented skin. Instead of using traditional filters, e.g. filter wheels, generalized Lyot filter, electrical tunable filter or the methods of dispersing light, e.g. optic-acoustic crystal, a novel custom filter mosaic has been successfully designed and fabricated using lithography and vacuum multi layer film technologies. The filter has been integrated with CMOS and CCD sensors. The filter incorporates four or more different wavelengths within the visual to nearinfrared range each having a narrow bandwidth of 30nm or less. Single wavelength area is chosen as 20.8μx 20.8μ. The filter can be deposited on regular optical glass as substrate or directly on a CMOS and CCD imaging sensor. This design permits a multi-spectral image to be acquired in a single exposure, thereby providing overwhelming convenience in multi spectral imaging acquisition.