The latest and therefore more efficient open magnetic resonance (MR) scanners with a field strength of 1 T allow freehand fluoroscopic interventions with excellent image quality. Specifically designed interactive software simplifies examination planning and performance. Guidance in two imaging planes allows fast and accurate device positioning and interventional procedures during free breathing. The diagnostic and therapeutic spectrum includes a wide variety of interstitial percutaneous interventions. The most important are periradicular therapy (PRT), intra-abdominal drainage and nephrostoma placement, biopsies, especially in the breasts and liver and focal ablation therapy of malignant hepatic or renal lesions. As the approach is fast and robotic devices are not needed the method is increasingly being carried out in the clinical routine. A drawback of MR-guided interventions is the limitation in verbal communication during image acquisition. Furthermore, the portfolio of MR compatible instruments needs to be extended.