Introduction. Today, many medical procedures are based on image analysis with the aim of providing accurate diagnosis and optimal treatment. The goal of this report was to present clinical implications of computer-assisted geometric design of carotid aneurysms. Material and methods. In this study, the three-dimensional reconstruction was based on the approximation power of the parametric spline function, which achieves interpolation and surface fitting of the arterial information obtained by conventional angiography. Two views of conventional angiograms (anterioposterior and lateral views) were used with a personal computer and commercial software. Results. This method of three-dimensional generated images was applied in 45 cases of cerebral aneurysms in carotid bifurcation. 3D reconstructions were made in approximately 20 minutes. They contributed to assessing vascular structures, and it was possible to rotate the three-dimensional image in different angles. Conclusion. Three-dimensional reconstruction of cerebral vessels is very useful for discussing surgical strategies preoperatively. Furthermore, it could also be used in endovascular procedures. .