Over the last two decades, interventional neuroradiologists have developed powerful techniques for the treatment of cerebrovascular disorders and brain tumors. Current interventional neuroradiological procedures are performed under X-ray fluoroscopy, which has allowed for high temporal and spatial resolution. However, these imaging techniques do not provide the treating physician with vital anatomic and functional information regarding vessel walls and the surrounding brain tissue. Better visualization of vessel structures and real-time information about the state of perfusion and metabolism of the surrounding brain tissue (real-time magnetic resonance arteriography, diffusion and perfusion-weighted imaging, apparent diffusion coefficient maps) would enhance safety and efficacy of neuroendovascular procedures available currently. Recent advances in magnetic resonance hardware and software have permitted significant enhancements in temporal and spatial resolution, which have resulted in the capability of visualizing anatomic structures with real-time fluoroscopy and angiography. This review outlines how real-time magnetic resonance procedures may replace conventional X-ray fluoroscopy in diagnostic and interventional neuroradiology during the next decade.