The use of magnetic resonance imaging (MRI) for image-guided intervention poses both great opportunity and challenges. Although MRI is distinguished by its excellent contrast resolution and lack of ionizing radiation, it was not till the 1990s that technologic innovations allowed for adoption of MRI as a guidance modality for intervention. With advances in magnet, protocol, coil, biopsy needle, and ablation probe design, MRI has emerged as a viable, and increasingly, preferable alternative to other image guidance modalities. With the development of targeting software, augmented reality, robotic assist devices, and MR thermometry, the future of MRI-guided interventions remains promising.