Radiographically guided percutaneous needle biopsy is a safe, accurate, well-tolerated alternative to laparotomy for confirmation of advanced abdominal malignancy. Here we describe the indications and methodology for its performance. Eighty-two percent of 66 patients with proven abdominal neoplasms were successfully biopsied with a fine-caliber needle using a variety of guidance methods. Cross-sectional techniques, such as ultrasound and computed body tomography (CBT), provide the preferred monitoring techniques because of their excellent soft-tissue resolution and the capacity to determine tumor depth accurately. The ability of CBT to define the exact position of the biopsy needle tip in a mass makes it the preferable guide for biopsing of small, solid lesions.