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A 3-D augmented reality navigation system using autostereoscopic images was developed for MRI-guided surgery. The 3-D images are created by employing an animated autostereoscopic image, integral videography (IV), which provides geometrically accurate 3-D spatial images and reproduces motion parallax without using any supplementary eyeglasses or tracking devices. The spatially projected 3-D images are superimposed onto the surgical area and viewed via a half-slivered mirror. A fast and accurate spatial image registration method was developed for intraoperative IV image-guided therapy. Preliminary experiments showed that the total system error in patient-to-image registration was 0.90 ± 0.21 mm, and the procedure time for guiding a needle toward a target was shortened by 75%. An animal experiment was also conducted to evaluate the performance of the system. The feasibility studies showed that augmented reality of the image overlay system could increase the surgical instrument placement accuracy and reduce the procedure time as a result of intuitive 3-D viewing.