Anatomic reduction and appropriate implant placement is essential for optimal treatment of intraarticular tibial plateau fractures. Standard intraoperative fluoroscopy provides limited visualization of the reduction and hardware placement compared with pre- or postoperative three-dimensional (3-D) imaging modalities. As such, postoperative computed tomography has become a common procedure to evaluate the quality of the reduction and fixation. The Iso-C3D provides 3-D intraoperative imaging to dynamically assess the surgical reduction and fixation at different anatomic regions. We report on our first 19 clinical tibial plateau fractures scanned intraoperatively with the Iso-C3D. When compared with conventional c-arm images, the Iso-C3D scans demonstrated improved ability to identify articular malreduction and implant malposition.