Three-dimensional ultrasound (3D US) is a new imaging modality, which is being introduced into clinical practice. Although this technique is unlikely to replace two-dimensional ultrasound, it is being increasingly used. It has been reported that 3D US is a high reproducible technique which has many applications in the field of Gynecology, as supported by a steady increase in the number of papers published in this area in the last few years. These applications include: imaging of the uterus, uterine cavity, adnexa and pelvic floor, as well as very interesting applications using threedimensional power-Doppler ultrasound. The aim of this work is to address some technical aspects of 3D US, to review critically its current status in clinical practice, and to project future perspectives of its use.