AbstractThe use of MRI to guide and monitor interventional procedures requires the merging of surgical and MRI environments. The ideal magnet shape for homogeneity and efficiency is spherical, but this design provides no access. Opening the sphere to provide both patient and surgeon access suggests cylindrical or biplanar magnets. Cylindrical magnets have poor surgical access but provide good imaging capabilities, which can be used in conjunction with a neighboring but distinct surgical environment. Biplanar magnets provide more and better approaches to the patient, but generally with lower field strength. Vertical biplanar systems allows surgical approaches from above but reduce the access of support staff to the patient. A hybrid magnet design, which combines the benefits of both cylindrical and biplanar magnets, can provide increased access with simultaneous approach from two sides of the patient. Application‐specific magnets can target a smaller region, leading to compact magnet designs that greatly expand access for both surgical intervention as well as patient support. As the field of interventional MRI matures, the suitability of each design to specific applications will be better understood, leading to more integrated system designs tailored to the needs of imageguided therap