OBJECTIVE The aim of this study was to evaluate the clinical application of the three-dimensional spiral CT in the complex maxillofacial fractures. METHODS A total of 26 patients with complex maxillofacial fractures were examined using spiral CT with the slice thickness of 3 to 5 mm. The surface shaded display (SSD) method was used for reconstruction of the three-dimensional (3D) images. The three-dimensional images of maxillofacial fractures were obtained by using various rotations. Before the three-dimensional images were reconstructed, the drawing and deleting way was used for these mandibular fractures. RESULTS The method demonstrated clearly the three-dimensional anatomy and their relationships of the fractures; using the drawing and deleting way, location and move condition of mandibular fractures, especially condylar fractures, were showed clearly. CONCLUSIONS The three-dimensional CT is important in evaluating complex maxillofacial fractures. It could be used to demonstrate clearly locations and move conditions of complex maxillofacial fractures and operative plans.