Objective To investigate the advantages of three-dimensional (3-D) reconstruction of nasal fractures with spiral computed tomography (CT) in comparison with roentgenography in medico-legal expertise. Methods CT scanning was performed in 32 cases with complex nasal fractures by Somatom Balance on 2mm/2mm scan. The images were reconstructed with maximum intensity projection (MIP), multi-plannar reconstruction (MPR), shaded surface display (SSD), and volume rendering (VR) mode and compared with roentgenographic images. Result Nasal fractures evaluated by roentgenography were detected to be false-positive in 3 cases and misdiagnosed fracture type in 6 cases as re-evaluated by 3-D reconstruction. Conclusion 3-D reconstruction images are of advantages over roentgenographic images in evaluation of broken bone fragments, displacement, fracture type for clinical diagnosis and medicolegal expertise.