Routine production of three dimensional (3-D) surface images from CT scans for clinical applications has been performed in 700 cases. These images have been found useful in craniofacial, orthopedic, and neurosurgical applications. Three dimensional images may be produced on the same CT scanner that collected the original slices. The emergence of 3-D imaging as a routine radiological procedure involves special technological requirements to avoid artifacts and to produce a useful result. Three dimensional surface reconstruction procedures are reviewed and examples of clinical application are presented.