Abstract For image-guided surgical procedures, the surgeon should be able to manipulate the imaging unit—and thus his visual feedback—himself and without delay. Intraoperative fluoroscopic imaging does not meet this demand, as the fluoroscope cannot be operated on by the surgeon himself. An interface named MEPUC (Motorized Exact Positioning Unit for C-Arm) was designed to optimize interaction between surgeon and fluoroscope. The hardware component of the MEPUC equips the fluoroscope with stepping motors. The software component of the MEPUC allows the surgeon control on motorized movements of the fluoroscope. Any fluoroscopic view defined by the surgeon can be obtained fully automatically when a MEPUC is combined with surgical navigation. Procedure time savings and staff reduction are expected from clinical application of the concept. The MEPUC adapts the fluoroscope to image-guided surgery.