Background <p>Transnodal x‑ray lymphangiography has become increasingly important in recent years as it enables precise visualization of the anatomy, function and pathologies of the central lymphatic system. It is usually performed after ultrasound-guided puncture of a&#xa0;lymph node with injection of an oily contrast medium.</p> Objective <p>The aim of this study is to present the basic principles of transnodal x‑ray lymphangiography and the interventional treatment options for central lymphatic pathologies.</p> Results <p>Regardless of the specific cause of the lymphatic pathology, transnodal lymphangiography is an effective and safe procedure which, in addition to its diagnostic value, can also have a&#xa0;therapeutic effect on lymphatic leakage. However, due to the employed oily contrast medium, it’s purely diagnostic use in patients with lymphoedema is not advisable.</p> Conclusion <p>Nodal lymphangiography also forms the basis for targeted interventional radiological treatments (e.g. lymph vessel embolization) of a&#xa0;wide range of often rare lymphatic diseases. Interventional methods are often more precise, faster and less-invasive than surgical procedures and have lower morbidity and mortality rates.</p>