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Lateral cephalometric radiograph produces a two-dimensional image with several drawbacks. Cone beam computed tomography (CBCT) allows obtaining a three-dimensional representation of the craniofacial structures and seems to overcome the problems of superimposition and magnification, providing more precision than two-dimensional methods. The aim of the current study was to test the intraobserver and interobserver reliability of linear and angular measurements performed on two-dimensional conventional cephalometric images and CBCT-generated cephalograms, and to evaluate if there is a statistically significant difference between the 2 methods of measurements. The sample group consisted of 24 adolescents with a pretreatment digital lateral radiograph and a corresponding CBCT image. A total of 16 cephalometric landmarks were identified and 17 widely used measurements (9 angular and 8 linear) were recorded by 2 independent observers. Intraobserver and interobserver reliability were assessed by calculating Pearson correlation coefficient. Student t-test was used to compare the 2 methods. The threshold for significance was set at P0.05.