The reconstruction of orbital fractures remains a challenge. Using computer assisted surgery (CAS) an intraoperative controll of the reduction allows for an effective and precise 3D reconstruction of the orbital caity in a single operation.The perliminary results of CAS orbital reconstruction based on cone beam CT scans (NewTom Model QR-DVT 9000, NewTom AG, Marburg) is repoted in five children (mean age 9 years). Preoperatively diplopia and enophthalmos was noted. The exported DICOM data were used with a STN workstation (Leibinger, Germany) for evaluation and preoperative planning and intraoperative CAS control of the orbital reconstruction.In 3 children younger than 9 years of age calvarium split grafts and in 2 children 11 and 13 years of age Titan-Mesh were used for orbital reconstruction by transconjunctival approach. The quality of the cone beam scans for CAS was comparable with standard CT scans. Two monaths postoperative none of the pediatric patients showed diplopia or enophthalmos. Schlagwörter: cone beam ct, orbital reconstruction