ObjectiveTo develop precise universal standard interventional spine nomenclature for reporting procedural details and anatomy. MethodsThere is no comprehensive nomenclature of spinal imaging anatomy that can be used for anatomical and procedural reporting. Given this critical lack of unifying terminology, a system of nomenclature was developed de novo by expert consensus, based upon clinical needs, and previously published reports. ResultsNomenclature for anatomical and spine procedural reporting for interlaminar and transforaminal approaches was developed using zones in each view. Separate nomenclature for medial branch procedural reporting and discs and vertebral body location and procedural reporting is also presented. ConclusionThere is a need for a unified anatomical location reporting system in interventional spine. The first step is the development of a precise, simple, and intuitive nomenclature, as reported here. The second is ratification followed by dissemination and adoption in clinical practice.