Objective To analyze the value of 3D reconstruction of MSCT in zygomatic zygomaticomandibular plastic surgery. Methods 80 patients undergoing zygomatic zygomaticomandibular plastic surgery in our hospital and the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University from February 2012 to April 2017 were selected as the subjects. They were examined by MSCT before and after the surgery.The images were processed by multi-planar reconstruction (MPR), threedimensional surface shaded display (SSD) and volume rendering technique(VRT). Image characteristics, bone structure before and after surgery, measured data of zygomatic arch shape, condyle and Spee curvature radius were analyzed. Results The 3D reconstruction of MSCT can clearly and visually display the stereoscopic anatomy morphology and detailed data of the zygomatic arch. The sagittal plane measurement showed that the spaces of temporomandibular joint at 120 degrees on the left side, 120 degrees on the right side, 180 degrees on the left side and 180 degrees on the right side at 6 months after surgery were smaller than those before the surgery (P<0.05).MPR showed that the zygomatic bone thickness, the thickness of thinnest zygomatic arch bone, average chord length of zygomatic arch and height of zygomatic arch after surgery were smaller than those before surgery (P<0.05), and they decreased by 4.04, 0.33, 1.13 and 1.52mm, respectively. There was no obvious change of space between condylar inner edges or space between condyle outer edges at 6 months and 8 months after surgery (P>0.05), but the Spee curvature radius at 8 months after surgery was shorter than that before surgery and at 6 months after surgery (P<0.05). Conclusion 3D reconstruction of MSCT is of high value in zygomatic zygomaticomandibular plastic surgery. It can well display the 3D stereoscopic anatomical structure of the zygomatic arch by MRP, SSD and VRT. It also can improve the accuracy of surgery.