Magnetic resonance (MR)-guided endovascular interventions are attractive since MR imaging provides high soft tissue contrast, the ability to perform angiography with and without the application of contrast medium, the possibility of assessing physiologic function, and the concept of “molecular imaging”. Actually, three groups of indications emerge: MR guidance of endovascular interventions is attractive for the treatment of patients with congenital heart diseases, electrophysiological interventions, and local delivery of drugs or other therapeutics. Currently different groups assemble the elements necessary for MR-guided endovascular interventions and develop dedicated protocols and procedures. However, these endovascular MR-guided interventions are still under development and have not yet entered the clinical arena. They are performed in patients only at a few specialized centers worldwide.