Three-dimensional volumetric imaging allows better visualization of the morphologic deformity, planning the surgical approach, and evaluating the response not visualized previously with two-dimensional dentofacial records. This in time will replace conventional two-dimensional cephalometric planning and plaster cast model surgery. Three-dimensional craniofacial imaging requires application of various techniques from applied mathematics, computer sciences, and bioengineering. Although it is today in its infancy, it has the potential to accurately simulate the operative experience for surgical planning, with improved morphologic outcomes, patient-specific biomechanical modeling to allow functional assessment of the various outcomes, and accurate simulation for surgical resident training.