This paper presents the design, modeling, and control of a meso-scale torsion actuator based on shape memory alloy (SMA) for image-guided surgical procedures. Developing a miniature torsion actuator is challenging, but it opens the possibility of significantly enhancing the robot agility and maneuverability. The proposed torsion actuator is bi-directionally actuated by a pair of antagonistic SMA torsion springs through alternate Joule heating and natural cooling. The torsion actuator is integrated into a surgical robot prototype to demonstrate its working performance in the humid environment under C-Arm CT image guidance.