Abstract: Objective To evaluate the value of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures (VRF). Methods Sixty-seven teeth suspected of VRF from 61 patients underwent periapical radiograph (PR) and CBCT. Then all subjects underwent surgical operation and direct visualization to confirm the presence or absence of VRF. The results were compared and analyzed statistically. Results Surgical operations confirmed the presence of VRF in 62 teeth. The positive rate, sensitivity and accuracy of VRF according to CBCT were 83.6%、90.3% and 91% respectively, while those of PR were 31.3%、33.9% and 38.8%, respectively（P＜0.01）. The sensitivity of CBCT for VRF in buccolingual and mesiodistal direction were 93.2% and 62.5%, which were higher than those of PR (69.6% and 12.8%)（P＜0.05）. Conclusions CBCT appears to be more accurate than PR in the diagnosis of VRF.