This study assessed the value of three-dimensional CT (3D CT) in the diagnosis of craniosynostosis, and correlated the cranial deformity with the presence of osseous defects in cranial vault's bones. One hundred and two children (55♀ and 47♂) with a clinical suspicion of craniosynostosis, underwent spiral computed tomography with 3D reconstruction using the shaded surface display (SSD) and volume rendering (VR) algorithms. We evaluated the presence of osseous defects in cranial bones in correlation with the type of craniosynostosis and the shape of the cranial vault. 3D CT allowed the evaluation of craniosynostosis in all patients. All patients had combined forms of craniosynostosis. Osseous defects in the bones of cranial vault were found in 56 patients of whom nine had scaphocephaly, eight plagiocephaly and one trigonocephaly. CT of the skull with three-dimensional reconstruction can safely and reliably identify craniosynostoses in children and could be used for the identification of osseous defects in the cranial vault.