Frame-based, frameless, and robotic stereotactic biopsy procedures each possess unique advantages and limitations that influence their clinical utility. Frame-based techniques offer reliability but are invasive and less flexible. Frameless approaches minimize invasiveness and allow trajectory adjustments, but they might be affected by inaccuracy concerns. Robotic systems while providing very high accuracy imply remarkably higher costs and a very steep learning curve. The technique choice depends on various factors such as the patient and lesion characteristics, the available technology, and the surgical team expertise. As technology evolves, a hybrid approach may emerge, combining the strengths of different techniques to optimize biopsy outcomes while minimizing both the disadvantages and the limitations of each one.