The purpose of this study was to evaluate the use of cone-beam computed tomography (CBCT) in postgraduate orthodontic residency programs. An anonymous electronic survey was sent to the program director/chair of each of the sixty-nine United States and Canadian postgraduate orthodontic programs, with thirty-six (52.2 percent) of these programs responding. Overall, 83.3 percent of programs reported having access to a CBCT scanner, while 73.3 percent reported regular usage. The vast majority (81.8 percent) used CBCT mainly for specific diagnostic purposes, while 18.2 percent (n=4) used CBCT as a diagnostic tool for every patient. Orthodontic residents received both didactic and practical (hands-on) training or solely didactic training in 59.1 percent and 31.8 percent of programs, respectively. Operation of the CBCT scanner was the responsibility of radiology technicians (54.4 percent), both radiology technicians and orthodontic residents (31.8 percent), and orthodontic residents alone (13.6 percent). Interpretation of CBCT results was the responsibility of a radiologist in 59.1 percent of programs, while residents were responsible for reading and referring abnormal findings in 31.8 percent of programs. Overall, postgraduate orthodontic program CBCT accessibility, usage, training, and interpretation were consistent in Eastern and Western regions, and most CBCT use was for specific diagnostic purposes of impacted/supernumerary teeth, craniofacial anomalies, and temporomandibular joint (TMJ) disorders.