Aim of the Study Evaluation of precision and reproducibility of the 3D facial images obtained from Planmeca ProMax 3D ProFace system by comparing them with direct anthropometry.Materials and Methods A diagnostic accuracy study was conducted including 46 participants (34 females and 34 males). They were imaged by Planmeca ProMax 3D ProFace system. 3D volumes obtained were uploaded on Planmeca Romexis 4.5.0.R software, 16 linear anthropometric measurements describing facial soft tissue parameters as described by Farkas were recorded. In addition, all participants had direct anthropometric measurements sessions using sliding and spreading calipers to record the same 16 linear anthropometric measurements. The digital measurements were repeated by the same operator twice with one week interval. Additionally, second observer repeated the same measurements to assess both intra and inter-observer reliability respectively. Mean values, mean difference and standard deviation with confidence interval 95% were estimated. For statistical analysis; Pearson correlation confident (r) and Bland-Altman test were used to evaluate the accuracy, Mean Absolute Difference (MAD) and Relative Error Magnitude were calculated to assess precision. For reprodcibilty; IntraClass Correlation Coefficient was done for Inter and Intra- observer reliability. Lastly for Bias assessment Paired t-test was calculated.ResultsDigital measurements obtained from Planmeca ProMax 3D ProFace facial imaging system were assessed in terms of accuracy, precision, bias, intra and inter observer reliability. Positive statistical significant correlation (r) between digital and direct measurements were found, further Coefficient of Variance (COV) ranged from 1.96% to 6.46% with mean COV 4.0125 % showed good to very good agreement between the two methods. Furthermore, the mean absolute difference (MAD) ranged from 1.2 to 6.95 with mean of 2.27625. While REM ranged from 1.96% to 6.46% with mean 4.0125 %, demonstrating good to very good precision between the two methods. Besides, the digital measuring method showed no bias though three measurements showed under-estimation in relation to direct method. Lastly intra and inter-observer reliability were assessed by Intraclass Correlation Coefficient (ICC). They ranged fromConclusion Good to very good accuracy of digital measurements obtained from Planmeca ProMax Proface in comparison to direct measurements. Digital measurements showed high precision in relation to direct measurements. The images obtained from Planmeca ProMax Proface could be considered of a good reproducibility. Digital measurements showed generally a good to excellent intra observer reliability between the measurements with one week interval. Inter observer reliability of the digital measurements between two different observers was good to excellent. Most of digital measurements were of no systemic bias except three measurements showed under estimation of the digital values in relation to direct measurements good to excellent relativity for digital measurements.