Endoscopic ultrasound-guided tissue acquisition by using fine needle biopsy (EUS-FNB) has been introduced so as to overcome the limitations of fine needle aspiration (FNA). There are currently several commercially available FNB needles now available. FNB allows for a superior diagnostic yield to FNA and allows us to obtain actual histologic tissue. Overall, the ability of EUS to obtain core tissue specimens from primary tumors, lymph nodes, the liver, and metastases makes these devices invaluable in the era of modern, interventional EUS. Ongoing studies will further clarify ideal needle types and sizes for different indications and target locations.