In the past three decades, hybrid imaging methods have expanded the boundaries of image-guided interventions. Hybrid imaging, which combines metabolic and anatomic information, offers the unique ability to simultaneously assess organ function and structure, as well as tumor anatomy and metabolic activity. One of the prime examples of hybrid imaging is PET/CT, wherein cross-sectional metabolic and anatomic images are created and subsequently fused via dedicated software. Multimodal fusion of PET with CT or ultrasound (US) images has proven invaluable in image-guided biopsies and tumor ablations. However, the technique continues to face limitations, notably challenges in registration accuracy [1]. Registering previously acquired diagnostic images with procedural images requires the resolution of differences in patient positioning, breathing patterns, and tissue or intraprocedural organ mobilization [2,3]. In this review, we summarize the well-established literature on the use of real-time PET/CT for intervention guidance, with a particular focus on biopsies, ablations, and transarterial therapies. Although various authors have previously published comprehensive descriptions of these procedures [4,5], we aim to provide updated insights into indications, techniques, clinical applications, advantages, limitations, and recent technological advancements.