Radio frequency (RF) ablation is the latest and most promising treatment for nonsurgical cancer patients. This article will explain the history of how RF ablation was developed, moving us through the quest for larger ablations. It will take the reader step by step through the actual procedure; explain the different RF systems available; describe the physics of how RF ablation works and why it is preferred over other predecessors, such as cryoablation, microwave ablation, laser ablation, chemoablation, and ethanol ablation; and describe the pitfalls of each. It will also mention the reasons why ultrasonography is the most popular guidance method, while computed tomography is used for follow-up.