Cone beam CT (CBCT) technology in interventional pulmonology is primarily used for advanced, 3-dimensional image guidance. It offers the possibility for precise, near-real-time guidance for navigation, biopsy and treatment of small, peripheral pulmonary nodules. Fixed CBCT systems are available as ceiling mounted or robotic floor-mounted systems and are integrated with the patient table. This combination offers the possibility for augmented fluoroscopy: an overlay of segmented target nodules and marked bronchial subsegments which can be projected on the live fluoroscopy imaging translating 3D information on 2D fluoroscopy. By using different angulations of fluoroscopy, this allows using CBCT as a single tool for navigation bronchoscopy. This workflow has a high diagnostic yield of 78.2% (95% CI 71.5–83.7, intermediate definition) as published in a meta-analysis. Mobile CBCT systems do currently not offer augmented fluoroscopy, but they can be integrated into, for example, robotic-assisted bronchoscopy and can thus compensate for CT-to-body divergence of the (robotic) navigation guidance technology. This combination of robotic bronchoscopy with CBCT translates into an increased diagnostic yield ranging from 75% to 93% in the currently available literature. CBCT imaging is an essential prerequisite for all forms of local treatments. CBCT navigation bronchoscopy has a low radiation exposure both for patient and staff and is a cost-effective strategy for diagnoses of peripheral pulmonary nodules.