We report the results of a randomized, controlled trial to compare the accuracy of standard ultrasound-guided needle biopsy to biopsies performed using a 3D Augmented Reality (AR) guidance system. Fifty core biopsies of breast phantoms were conducted by a board-certified radiologist, with each set of five biopsies randomly assigned to one of the methods. The raw ultrasound data from each biopsy was recorded. Another board-certified radiologist, blinded to the actual biopsy guidance mechanism, evaluated the ultrasound recordings and determined the distance of the biopsy from the ideal position. A repeated measures analysis of variance indicated that the head-mounted display method led to a statistically significantly smaller mean deviation from the desired target than did the CRT display method. (2.48mm for control versus 1.62mm for augmented reality, p < 0.02). This result suggests that AR systems can offer improved accuracy over traditional biopsy guidance methods.