Despite advances in radiology -- including CT scanning -- three-dimensional (3D) nature of facial bone fractures must be inferred by the spatial imagination of the physician. Thus, in order to assess the usefulness of 3D-CT, 3D-CT reformations were obtained in 24 patients presenting with facial injuries of differing severity from 7. 1993 to 5. 1995. The 3D images were compared with high resolution CT, including multiplanar reformations, and assessed under the headings of fracture detection, extent and displacement using a single scoring system.3D was valuable in extensive facial fractures, providing a clear demonstration of fracture extent and fragment displacement. 3D was equally useful in the diagnosis of malar complex fractures and mandible fractures. However, 3D was much less useful in the diagnosis of orbital blow-out fractures and minor trauma, in which little or no fragment displacement had occurred, than conventional CT. In conclusion, when used as part of a high resolution CT examination, 3D imaging can provide useful information to surgeon in cases of severe facial trauma.