This IAEA Human Health Series publication provides comprehensive guidance on quality assurance and optimization in fluoroscopically guided interventional procedures (FGIPs). Designed for a diverse range of clinical specialists, it emphasizes the critical role of radiology medical physicists in establishing robust quality assurance programmes. By outlining best practices, standardizing protocols and emphasizing the integration of cutting edge technology with evidence based medicine, this publication aims to support healthcare providers in offering FGIPs that are patient-centred and in line with global standards.