In recent years, systems for the three-dimensional (3-D) reconstruction of intravascular ultrasound (IVUS) images have been developed. As a major advantage over conventional two-dimensional IVUS, 3-D IVUS offers longitudinal views of the reconstructed segments and provide more comprehensive insight into the spatial distribution of vascular structures. The present article is an overview of current 3-D reconstruction techniques. In particular, we discuss the sequence of basic steps required to obtain a 3-D reconstruction: IVUS image acquisition, digitization, segmentation and reconstruction. We also illustrate the different systems of 3-D reconstruction that are currently available. Some of them can be used on-line during surgical procedures, while others are more suited for off-line applications and are useful research tools.