MRI has made dramatic contributions and is well known for its role in medical diagnostics. However, its contributions to therapeutics is less mature despite the excellent soft tissue contrast that the modality provides. Approximately a decade ago, the MRI research group at Case Western Reserve University, and others, began developing the MRI hardware, software, data acquisition strategies, and reconstruction methods to facilitate image guided procedures performed with MRI. This talk will focus on the unique engineering contributions in MR physics like real-time imaging, electronic devices like catheter based receiver coils, and others that facilitated not only interventional MRI for initially cancer, but also more recently cardiovascular procedures like imaging of the vessel wall and arterial stenting done completely with MRI. The development of MRI has been driven largely by biomedical engineers whose understanding of MR technology, physiology, signal processing, mathematics and instrumentation.