This paper describes the design, manufacture, and performance of a highly dexterous, low-profile, 7 Degreeof-Freedom (DoF) robotic arm for CT-guided percutaneous needle biopsy. Direct CT guidance allows physicians to localize tumours quickly; however, needle insertion is still performed by hand. This system is mounted to a fully active motion stage superior to the patient's head and teleoperated by a radiologist. Unlike other similar robots, this robot's fully seriallink approach uses a unique combination of belt and cable drives for high-transparency and minimal-backlash, allowing for an expansive working area and numerous approach angles to targets, all while maintaining a small in-bore cross-section of less than 16cm 2 . Simulations verified the system's expansive collision free work-space and ability to hit targets across the entire chest, as required for lung cancer biopsy. Targeting error was on average < 1mm on a teleoperated accuracy task, illustrating the system's sufficient accuracy to perform biopsy procedures. While this system was developed for lung biopsies, it can be easily modified for other CT-guided needle based procedures. Additionally, this system is open-hardware. 1 †