Cone-beam computed tomography (CBCT) has become a cornerstone of modern dentomaxillofacial diagnostics by enabling high-resolution, three-dimensional visualization of osseous structures with optimized radiation dose profiles. This chapter provides a comprehensive and systematic exploration of CBCT as a diagnostic modality, beginning with its physical principles, X-ray generation, cone-beam geometry, detector technology, and data acquisition strategies. Detailed emphasis is placed on image reconstruction processes, including raw data acquisition, the Feldkamp–Davis–Kress algorithm, voxel formation, and the clinical implications of isotropic voxel architecture. Determinants of image quality—such as spatial and contrast resolution, noise behavior, voxel size, field-of-view selection, partial volume effects, and motion artifacts—are critically examined to highlight their impact on diagnostic reliability. This chapter further elaborates on advanced image display and visualization techniques, including multiplanar reformation, selective projection methods, full volume rendering, surface rendering, and cinematic rendering, underscoring their interpretive strengths and limitations. Common CBCT artifacts, technical constraints, and safety considerations are systematically discussed to promote judicious clinical application. Finally, emerging developments in reconstruction algorithms, artificial intelligence integration, multimodal imaging fusion, and dose optimization are presented as future directions shaping the evolution of CBCT from a structural imaging tool toward an intelligent, decision-supportive diagnostic platform in contemporary dental practice.