A needle guide for use with a medical ultrasonic scanning apparatus includes a pivoting plate on a fixed mounting plate. The mounting plate is attached to an ultrasonic scanhead whereby a surface of the mounting plate is in the plane of the ultrasound scan. An adjustable pivoting plate on the mounting plate includes at least one needle aligner, which preferably has a groove formed therein. The pivoting plate can be pivoted and locked into position on the mounting plate. An idler plate, containing an idler roller is spring mounted on the pivoting plate. The idler plate can be pivoted, whereby the idler roller moves away from the guide needle aligners. A raised wall on the pivoting plate prevents an improperly placed needle from puncturing a sterile sheath applied over the scanhead, such as in a brain scan. Thus a needle, such as a biopsy needle can be placed between the idler roller and the needle aligner and will be held in place by the spring tension on the idler roller.