Accurate registration of facial surface anatomy by imaging system is essential for three-dimensional quantitative analysis of facial shape. Objectives: To assess the reliability of a light-based facial imaging system in registering a complex object and evaluating the reliability of interactive localization of anthropometric landmarks on three-dimensional facial images. Methods: The study was carried out on dry skull and live patient using the FaceVision 600 light-based facial scanner (Geometrix Inc, California, USA). Landmark localization and linear measurements were performed with the RapidForm 2004 software (INUS Technology, South Korea). Ten serial three-dimensional images of a dry human skull with 8 steel ball bearings acting as visual cues for landmark localization were obtained. The scanning protocol for the dry skull was repeated 2 weeks later. Interactive computer landmark localization produced x, y, and z coordinates for each landmark on the dry skull. Ten facial images of a live subject with and without 8 pre-labeled anatomic landmarks were obtained, respectively. Images were obtained without varying the scanning protocol. Interactive computer landmark localization produced x, y, and z coordinates for each landmark. Measurements for inter-canthal width, inter-alar width and inter-cupid width were taken as linear measures along the most direct line between two respective landmarks on the facial surface. Inter-commissure width was taken as a straight line linear measure. Results: For the skull images taken at 2 weeks apart, Bland Altman Plots show all pairs of measurements for all 8 landmarks were found to lie within 95% limits of agreement. For the facial images, Bland Altman Plots showed all pairs of intercanthal, inter-alar, inter-cupid, and inter-commissure measurements with and without landmarks to lie within 95% limits of agreement. Conclusions: Data from both experiments show that the FaceVision 600 facial imaging system is a reliable clinical tool for three-dimensional quantitative assessment of frontal facial surface anatomy.