OBJECTIVE: The aim of this study is to compare the diagnostic value of two-dimensional (2D) CT and three-dimensional (3D) CT reconstruction techniques in detecting maxillofacial fractures in patients at Mzuzu Central Hospital (MCH). METHODS: 67 maxillofacial trauma patients admitted to Mzuzu Central Hospital from Jan to Sep 2024 underwent multi-slice spiral CT (MSCT) scanning. Images were post-processed using 2D and 3D reconstruction techniques. Clinical and radiological data were collected from the patients, and a comparative analysis of the results from the two reconstruction techniques was performed. RESULTS: In this study, 52 cases of maxillofacial fractures with a total of 83 fractures were diagnosed by 2D CT reconstruction technology, with a fracture detection rate of 77.61% (52/67). Using 3D CT reconstruction technology, 54 cases of maxillofacial fractures with a total of 91 fractures were diagnosed, and the fracture detection rate was 80.60% (54/67). Statistical analysis showed no significant difference in the detection rate of maxillofacial fractures between 2D CT and 3D CT reconstruction (χ CONCLUSION: 2D CT reconstruction is a basic diagnostic tool for maxillofacial fractures. 3D reconstruction, with high detection and multi-angle visualization, offers valuable imaging for clinical decision-making, aiding in surgery planning. A combined approach, leveraging the strengths of both modalities, is pivotal for comprehensive assessment and management of maxillofacial trauma.