Purpose: Development and clinical testing of an MR-compatible bone biopsy system, to enable the sample collection from osteosclerotic or subcortical lesions for histological investigation under MR control. Materials and Methods: A piezoelectrically driven drilling machine was constructed and tested in connection with an MR-compatible bone biopsy set in a vertical open MR scanner (0.5 T) on a phantom and 10 patients with ambiguous bone lesions. Images were obtained using T₁-weighted spin-echo sequences and, in case of real-time imaging, a fast spoiled gradient-echo sequence. Results: The influence of the enabled motor (RF- interference) leads to a reduction of the signal to noise ratio of the images, but can be minimised by appropriate measures. The observed slight field distorsions do not affect the image quality during real time acquisition in a substantial manner. No complications occurred. The extracted biopsy material was sufficient and of good quality. Conclusions: In spite of slightly restricted image quality, the described drilling machine combined with the bone biopsy set is well suited for MR-guided bone biopsies, which require the application of a motor driven drill. Its application within an interventional MR scanner is safe and its handling simple and manageable.