Introduction Interventional radiology is a medical procedure presenting a risk of significant exposure to ionizing radiations for the patient, but also for the medical staff close to the operating table. Nowadays Monte Carlo simulation is one of the most accurate means for estimating dosimetric quantities, but the important computation time remains one of the main limitations to its clinical use. In this context, a Monte Carlo program is being developed to allow a rapid and automated post-operative calculation of a patient’s dosimetric quantities (dose to the organs, skin dose maps) and a real-time visualization of the 3D dose field in the operating room. Methods The proposed program uses the Monte Carlo GATE simulation code, a reference in the field of dosimetry [1] , combined with advanced variance reduction methods (TLE, seTLE [2] ). Post-operative patient dosimetry calculations use the parameters provided by the machine (DICOM images), as well as experimental measurements with a device specifically developed for this application. Regarding the radioprotection of the medical staff, the real-time visualization of the dose field in the operating room is based on the prior creation of a database specific to the installation. Results The comparison of the first Monte Carlo results, with on-site ionization chamber measurements, showed a difference of less than 5% for the reconstruction of kerma in air in the primary beam and less than 10% for that of the scattered beam at one meter from the operating table. The use of variance reduction methods allows a post-operative calculation of the patient dose to be made in less than 15 min with a statistical uncertainty less than 5%. Conclusions By combining a reduced execution time and a precise modelization of interventions, the developed program makes these Monte Carlo calculations compatible with clinical routine use. It provides a realistic estimation of the dose delivered to the patient in case of overexposure and allows the medical staff an immediate assessment of the risk associated with the exposure to ionizing radiations during surgery.