Ultrasound-guided interventions have revolutionized the everyday clinical practice during recent decades. The new interventional ultrasound (INVUS) guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) are an expression of interdisciplinary and multiprofessional viewpoints, some of which represent different approaches; this reflects reality in all its diversity. Particular attention has been given to clinical significance including the level of evidence and the more practical grade of recommendation. The review refers to the history of interventional ultrasound and comments on the current EFSUMB guidelines.