The field of image-guided neurosurgery has developed under the premise that integrating the enhanced discrimination powers of CT scan and MR imaging into the operating room improves the accuracy, safety and precision of neurosurgery, and expand the realm of surgically treatable lesions. Through cooperation between General Electric Corporation and the Brigham and Women's Hospital, and open-configuration MR suite was designed and implemented to attain these goals through real-time, intraoperative MR imaging in a true surgical suite. This system allows intraoperative acquisition of MR images without moving the patient, online image-guided stereotaxy without preoperative imaging, and "real-time" tracking of instruments in the operative field registered to the MR images. The design and implementation of neurosurgery in the open-configuration MR imaging suite are summarized in this article.