Despite the fact that MR guidance is cost-intensive compared with ultrasound and CT guidance, there is a growing role for MR-guided interventions. Obviously, tumors only visible by MR imaging, such as breast and prostate lesions are major indications. But beyond this, the imaging feature of MR imaging allowing temperature measurements has been developed to a state allowing for clinical use. Especially thermal ablation therapies—and among these, focused ultrasound—are controlled by MR imaging and offer a truly noninvasive combination of ablation therapy. The high-energy focused ultrasound (HIFU)-based treatment of uterine fibroids, bone pain, breast and prostate cancer, and the treatment of essential tremor as the first neurological form of application have already been approved in several countries.