Radiofrequency ablation (RFA) provides an effective technique for minimally invasive tissue destruction. An alternating current delivered via a needle electrode causes localized ionic agitation and frictional heating of the tissue around the needle. Image-guided, percutaneous ablation techniques have been developed in most parts of the body, but the most widely accepted applications are for the treatment of hepatocellular carcinoma (HCC) in early cirrhosis, inoperable colorectal liver metastases, inoperable renal cell carcinoma and inoperable primary or secondary lung tumors. The procedures are well tolerated and the complication rates low. Most treatments in the lung, kidney and for HCC are performed under conscious sedation with an overnight hospital stay or as a day-case. Limitations of RFA include the volume of tissue that can be ablated and  most centers will treat 3–5 tumors up to 4–5 cm in diameter. Early series reporting technical success and complications are available for lung and renal ablation. Liver ablation is better established and 5-year survival figures are available from several centers. In patients with limited but inoperable colorectal metastases, the 5-year survival ranges from
26 to 30% and for HCC it is just under 50%. In summary, RFA provides the opportunity for localized tissue destruction of limited volumes of tumor; it can be offered to nonsurgical candidates and used in conjunction with systemic therapy.