Highly collimated synchrotron sources are the essential ingredient of novel radiology and micro-radiology techniques for materials science, medicine and biology—with contrast based on the refractive index rather than on absorption. We were able to implement a real-time version of such techniques. Successful test studies included thin-foil breaking and electrodeposition processes in the areas concerning materials properties. Meanwhile, extensive effort was dedicated to obtain high-quality X-ray images of live specimens on a microscopic scale and in real time. These tests achieved a lateral resolution better than 2 μm and a time per image of 10 ms, with clear potential for further improvements. The images revealed in great detail moving parts of different specimens, opening the way to a wide variety of applications in the life sciences, medicine and materials science.