MRI-guided focused ultrasound thalamotomy has proved an effective method for the treatment of Essential Tremor. Precise alignment of the focus to the target in the thalamus is crucial. Proper targeting is complicated by artifactual shifts in hot spot location, with respect to anatomical images. We identified two sources of errors and proposed solutions to both; the correction scheme does not require any modification to the pulse sequence or imaging protocol. Shifts by 1.0±0.1 mm were detected and corrected, for three separate sonications in one given patient. The size of the shifts agreed with observations from the literature.