3-D reconstructions of the skull base, temporal bone, and skull fractures were compared to 2-D- CT to evaluate the diagnostic value in traumatized patients. 38 patients with 22 fractures of the facial skeleton (orbita, zygomatic, Le Fort), 12 temporal bone, and 4 skull fractures were investigated. Subjective grading was performed by two physicians (ENT/RAD) in respect of quality diagnostic validity and estimated clinical impact. The average image validity and quality were graded good. In the temporal bone the average information supplied by 3-D was of inferior value; here, the lack of information regarding the inner ear structures was responsible for the lack of clinical impact. In fractures of the facial skeleton and the skull base a good to very good image quality was seen and clinical relevance was high. 3-D CT is capable of demonstrating fractures, which is of little value in the temporal bone, but of high value in the skull base and the facial skeleton, especially if surfaces are involved or fragments are displaced.