In foot and ankle surgery accurate fracture reduction and implant placement may be challenging. Fracture malreduction or implant malposition may remain undetected with use of conventional fluoroscopy and are often only recognized on postoperative computed tomography (CT) scans. The development of a three-dimensional (3D) mobile imaging system has provided intraoperative control of fracture reduction and implant position. Three-dimensional computer assisted surgery (3D-CAS) has demonstrated improved accuracy in spine and pelvic surgery. Recently, the application of 3D-CAS in the field of foot and ankle surgery has shown very promising preliminary results. It appears that the intraoperative use of 3D imaging will become a standard of care.