A biopsy needle guide comprises a base, a flexible strap, a bracket, a needle guide bracket, and several locking mechanisms. The base has a first locking mechanism and a concave inner surface that conforms with an ultrasound probe. The flexible strap has a first end coupled to the base and a second free end coupled to the base with the first locking mechanism. The bracket is slidably disposed in a slotted region in the base. The needle guide bracket is configured to receive a biopsy needle guide and the needle guide bracket is slidably disposed in a slotted region in the bracket. Other locking mechanisms permit or prevent movement of the bracket relative to the base as well as movement of the needle guide bracket relative to the bracket.