Stereotactic neurosurgical interventions are characterized by a high risk of rupturing intracranial vessels or damaging vital brain structures. By MRI and MRA, the anatomic information necessary for stereotactic treatment planning may be assessed with a single modality as a high-resolution digital image volume. The adequacy of MR as a modality for stereotactic guidance is demonstrated by the example of the radiosurgical treatment of cerebral angiomas. An optimized acquisition protocol, a stereotactic apparatus, a distortion correction and minimization method, and a 3D treatment planning workstation are elements of a proposed preoperative approach which in a clinical study met with good acceptance.