An ultrasonic imaging system is used to observe and guide insertion of a needle into the body to access a targeted surgical site. A two dimensional array probe scans a volumetric region including the surgical site and a multiplanar reformatter formats the resulting 3D echo dataset to form a sequence of spatially adjacent images in real time. A plurality of the spatially adjacent images are concurrently displayed in real time. As the clinician inserts the needle into the body its progress of insertion may be observed in one plane. But if the insertion path of the needle is not constrained to one plane but passes through numerous planes, the insertion path is seen in successive ones of the concurrently displayed adjacent images.