Magnetic resonance image (MRI) guided tissue penetrating catheters and their methods of use. One or more MRI apparatus (e.g., one or more coils) are positioned on or in a catheter device that includes a tissue penetrator that may be used to form a penetration tract from a body lumen in which the catheter is positioned to a target location outside of that body lumen. The MRI apparatus (e.g., coil(s)) is/are used in conjunction with an MRI imaging system to indicate the position and/or rotational orientation of the penetrating catheter within the subject's body.