The use of magnetic resonance imaging to directly guide therapy is a new area of investigation. Clinical magnetic resonance imaging has the potential to evolve from a purely diagnostic tool into a guide for invasive procedures. The idea of using magnetic resonance to guide percutaneous biopsy developed one decade ago. Magnetic resonance-guided fine-needle aspiration for head and neck lesions has become a standard technique some institutions. Once the needle reaches a lesion in the head and neck, it is natural to explore the possibility of treatment in the same setting. The concept of interventional magnetic resonance imaging has generated interest among radiologists, surgeons, and manufacturers. This article provides an overview of interventional procedures of the head and neck and other new imaging techniques that have been developed.