Virtually all regions of the body may be accessed by CT- or MR-guided punctures. Depending on the region that needs to be accessed for diagnostic or therapeutic purposes, a variety of more or less safe routes are available. Depending on the anticipated route, adequate patient position and materials need to be selected, while the method for image guidance should depend on lesion visibility. The figures shown only provide a glimpse at the potential access routes to different parts of the body, and depending on the individual patient, the access routes may vary widely. The general principle, however, is always the same: the shortest way with as little angulation as possible, avoid nerves, vessels, lung, and hollow organs, and select the least traumatic puncture device that is reasonable for the anticipated task. If these basic requirements are considered, a safe and successful puncture will be achieved.