Balanced steady-state free precession (SSFP) sequences are useful in cardiac imaging because they achieve high signal efficiency and excellent blood-myocardium contrast. Spiral imaging enables the efficient acquisition of cardiac images with reduced flow and motion artifacts. Balanced SSFP has been combined with spiral imaging for real-time interactive cardiac MRI. New features of this method to enable scanning in a clinical setting include short, first-moment nulled spiral trajectories and interactive control over the spatial location of banding artifacts (SSFP-specific signal variations). The feasibility of spiral balanced SSFP cardiac imaging at 1.5 T is demonstrated. In observations from over 40 volunteer and patient studies, spiral balanced SSFP imaging shows significantly improved contrast compared to spiral gradient-spoiled imaging, producing better visualization of cardiac function, improved localization, and reduced flow artifacts from blood.