Objective：To evaluate the reliability of cone-beam computed tomography (CBCT) on identification of facial symmetry landmarks，and provide evidences for the measurement and analysis of three-dimensional facial symmetry. Methods：The CBCT images of 57 orthodontic patients were measured by multi planar reconstruction (sagittal，axial and coronal to the point) by using mimics 10.0 software to calibrate 28 facial symmetry related landmarks. There were 2 observers in this study，each observer had repeated 3 times with 2 weeks and 4 weeks intervals，respectively. The intra- and inter-class correlation coefficient (ICC) of each dimension coordinate value of each landmark was calculated to evaluate the reliability of the landmarks for intra-observer and inter-observer. Results：The ICCs of Ba，PNS，Cg，N，Antcr (L，R)，D'(L，R)，K (L，R)，Maz (L，R)，Or (L，R)，Zyg (L，R)，Cd (L，R) were with high reliability，and could be used for the analysis of CBCT three-dimensional cephalometry of facial symmetry. Conclusion：In this study，there are 19 in 28 facial symmetry related landmarks with high reliability，which are of great value in clinical practice.