Published reports of magnetic resonance (MR)-guided needle biopsy have involved low- and mid-field-strength systems because of the concern of needle artifact and risk of increased needle torque at higher field strengths. To the authors' knowledge, this is the first report of a high-field-strength (1.5-T) system used to guide aspiration cytology in the head and neck in a patient. The procedure was successfully accomplished without additional needle torque or substantial increase in image artifact relative to lower-field-strength imaging.