The use ofthe radiographic-fluoroscopic-tubelight localizer in conjunction with fluoroscopically guided percutaneous procedures can reduce the amount of fluoroscopy time necessary. When the needle hub shadow is projected directly over the point of entrance of the needle into the skin, the fluoroscopic central ray, the needle, and the structure to be punctured (previously centered fluoroscopically) are all coaxial, and the needle can be advanced with the light localizer substituting for much of the fluoroscopy.This technique is applicable for all equipment in which the fluoroscopic X-ray tube, equipped with a light localizer, is used.