Stereotactic biopsies are frequently performed to secure definitive diagnosis for brain tumor patients. Fundamentally, there are two major difficulties in these endeavors. First, because of intra-tumoral heterogeneity inherent in many forms of brain cancer, biopsies taken from one region may yield a different diagnosis than if another area is biopsied. Second, stereotactic needle biopsies inherently rely on mathematical algorithms for targeting, without real-time visualization of the actual biopsy site. This article describes the novel MRI-based technologies that can potentially afford neurosurgeons the opportunity to address these challenges.