A real-time mechanical sector scanner and attachable biopsy apparatus was used to guide fine-needle aspirations of 61 consecutive abdominal masses suspected of representing metastatic or primary malignant disease. Among these 61 patients, 15 had pancreatic masses and 32 had hepatic lesions, either solitary or multiple. The other 14 patients had possible recurrence of gynecologic malignancy either locally or within the retroperitoneum, or abdominal wall or retroperitoneal masses. Although various methods of fine-needle biopsy with real-time guidance have been described, the advantages and actual accuracy of this method have not been emphasized adequately. This technique was accurate in 57 (93.4%) of 61 cases, with only two apparent instances of incorrect needle placement. Although many institutions prefer CT guidance over sonography, this method offers numerous advantages and should be the method of choice in fine-needle biopsy guidance in the oncologic population.