With real-time instrument tracking and in-situ guidance projection directly integrated in a handheld ultrasound imaging probe, needle-based interventions such as biopsies become much simpler to perform than with conventionally-navigated systems. Stereo imaging with needle detection can be made sufficiently robust and accurate to serve as primary navigation input. We describe the low-cost, easy-to-use approach used in the Clear Guide ONE generic navigation accessory for ultrasound machines, outline different available guidance methods, and provide accuracy results from phantom trials.