Different cephalometric lines or planes may be used to determine vertical head tilt. 94 subjects were used to assess the difference in inclination between the Frankfurt horizontal and Reid's line by means of a photographic method. We found that the inclination of Reid's line differs about 13 degrees from the inclination of the Frankfurt horizontal and depends on the subject's sex but not on their age. Hand held inclinometer are used in most studies for determining the inclination of the head. In our study different experimenters assessed the above mentioned inclinations at our 94 subject's using a hand held inclinometer. It turned out that the results depend statistically significant on the experimenter. Data were compared to the ones assessed using the photographic method. By means of an analysis of variance in which the experimenter is considered, a significant correlation (p < 0.001) between data assessed with the two different methods was found. However, only 51% of the variance can be explained by our model. Variance might be due to inaccuracy in determining some of the points defining the Frankfurt horizontal and Reid's line, i.e. the lower orbit and the centre of the outer ear channel. The inclination of another reference line running from the tragion to the outer canthus was measured using the same subjects and the same experimental procedure as mentioned above. This line is easier to determine than the Frankfurt horizontal or Reid's line as its defining points can be assessed with greater accuracy. The inclination of this differs 10.5 degrees from the one of the Frankfurt horizontal.