MR-guided High-Intensity Focused ultrasound (MRgFUS) is an emerging approach to incisionless surgery that combines precise delivery of focused ultrasound (FUS) with MR image guidance. MRgFUS is a totally noninvasive therapy. In several centers, it has already become a routine procedure for uterine fibroids; other indications have currently to be considered experimental. Indications for MRgFUS are likely to expand dramatically following modifications and improvements of current technologies. Additionally, MRgFUS is an investigative but promising technology in the field of oncology, with potential for integration in current curative and palliative cancer treatment strategies. The results of MRgFUS for the ablation of uterine fibroids are comparable with surgery in terms of symptom reduction, resulting in a substantial improvement in quality of life after 12 months. It can be used for treating patients with symptomatic fibroids as well as in case of childbearing wish. The indication, however, has to be weighed against routine techniques like surgery and embolization.