Since the introduction of Cone Beam computed tomography (CBCT) in dentistry, it has become an increasingly important source of 3D volumetric information in clinical orthodontics. Over this period, valuable CBCT data have been gathered on 3D craniofacial morphology in health and disease, treatment outcomes and the efficacy of CBCT in diagnosis and treatment planning. Although, CBCT continues to gain popularity, its use currently is recommended in cases in which clinical examination supplemented with conventional radiography cannot supply satisfactory diagnostic information. To date, this applies to impacted teeth, CL/P and orthognathic or craniofacial surgery patients. CBCT on other types of cases can also be performed where there is likely to be a positive benefit-to-risk outcome such as supernumerary teeth, identification of root resorption caused by unerupted teeth, evaluating boundary conditions, TMJ degeneration and progressive bite changes and for placement of TADs in complex situations. Based on research evidence, orthodontists are advised to use their best clinical judgment when prescribing radiographs, including CBCT scans.