With today's imaging technology, relatively invasive procedures can be performed in the radiology department without significant complication. Biopsies, in particular, are frequently performed using computed tomography (CT) or ultrasound (US) guidance. In this article, both the indications and methods for imaging-guided percutaneous biopsy of the kidney and adrenal gland are reviewed. Citing the experience of several authors, the accuracy and complications of such procedures are also discussed.