Three-dimensional reconstructive cone-beam computed tomography (CBCT) enables high-fidelity assessment of maxillofacial trauma at comparatively low radiation dose. It provides isotropic volumes that support precise multiplanar and surface reconstructions suitable for diagnosis and planning. Beyond fracture detection, CBCT datasets delineate fracture trajectories, quantify displacement, map maxillofacial buttresses, restore symmetry through contralateral mirroring, integrate intraoral scans for occlusal analysis, and allow measurement of orbital contours and volumes. A reproducible workflow links trauma-appropriate patient stabilization with field-of-view and voxel selection consistent with ALADA, standardized reorientation, artifact control, segmentation of bone fragments, and registration with mirroring to create models usable for virtual surgical planning. The same reconstructions guide fabrication of splints and cutting guides and the design of patient-specific implants. They also facilitate postoperative verification of reduction, evaluation of hardware position, and targeted follow-up of orbital, condylar, and sinonasal regions. This chapter highlights principles of acquisition and reconstruction, region-specific protocols for mandible, midface and zygomaticomaxillary complex, orbit and naso-orbito-ethmoid, dentoalveolar, and panfacial injuries, as well as indications, limitations, and current developments such as semi-automated segmentation, symmetry analysis, and dose-aware protocol optimization.