Three dimensional imaging of the liver is focused on the spatial visualization of focal lesions in relation to vascular landmarks to support surgical decision making. Additionally the volume estimation of metastases or liver segments is considered in the patient's oncologic follow-up and the planning of the surgical approach. Spiral-CT is destined for 3D imaging, as it represents a standardized, minor invasive, time and cost saving method. Current developments of 3D sonography of the liver are reported. While a special application of 3D imaging, i.e. CT angiography (CTA), replaces preoperative arterial angiography in liver transplantation candidates the diagnostic gold standard for lesion detection still remains by reason of missing algorithms the interpretation of a 2D data set. Validation of 3D versus 2D imaging of the liver demands controlled trials to evaluate the diagnostic potential, time and cost savings of dedicated acquisition techniques, postprocessing algorithms and display modalities.