Background <p>Three-dimensional (3D) stereophotogrammetry has become an essential tool in anthropometry for both clinical and aesthetic purposes. However, to our knowledge, no standardized and validated 3D protocol specifically targeting the midface region currently exists. This study aimed to develop a standardized 3D anthropometric protocol for the midface region and to assess its reliability.</p> Methods <p>Twenty-eight female participants and nine male participants (74 midfaces; mean age 30.3±7.2&#xa0;years) were enrolled. For each participant, two sets of 3D facial images were acquired using the VECTRA H2 imaging system. Each image set was independently measured twice by two trained raters. A total of 34 anatomical landmarks were identified to partition the midface into 13 predefined zones. Based on these landmarks and zones, 13 surface area-based measurements, along with 13 volumetric, 4 angular, and 5 linear measurements, were obtained. Intrarater, interrater, and intramethod reliability were assessed.</p> Results <p>The protocol demonstrated high reliability across all assessments, characterized by low measurement error and excellent agreements. Intrarater, interrater, and intramethod analyses yielded consistently high intraclass correlation coefficient greater than 0.95, supporting strong measurement reproducibility.</p> Conclusions <p>The proposed protocol using 3D stereophotogrammetry is reliable and reproducible for midface anthropometric evaluation. It holds promise for application in clinical contexts including facial morphology assessment, surgical planning, and outcome evaluation in facial contouring and related interventions.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>