Orthopantomography remains a cornerstone imaging modality in oral and maxillofacial radiology, providing comprehensive visualization of the jaws, dentition, temporomandibular joints, and adjacent anatomical structures within a single, low-dose examination. Despite its two-dimensional nature and inherent geometric limitations, panoramic imaging continues to evolve through advances in detector technology, digital reconstruction, computational imaging, and intelligent workflow integration. Contemporary orthopantomographic systems have transitioned from mechanically constrained film–screen techniques to fully digital, software-driven platforms capable of adaptive focal trough modeling, multi-layer reconstruction, distortion correction, and motion compensation. These developments have significantly enhanced image consistency, diagnostic reliability, and radiation dose efficiency. This chapter critically examines the evolution of orthopantomographic imaging, emphasizing modern detector technologies, advanced reconstruction methodologies, integration with cone-beam computed tomography, artificial intelligence–assisted analysis, and digital clinical workflows. By linking physical principles with technological innovation and clinical application, this chapter highlights how panoramic imaging has transformed from a static screening tool into a dynamic and intelligent diagnostic modality. The discussion highlights the sustained relevance of orthopantomography in contemporary practice and its expanding role within integrated, precision-oriented maxillofacial imaging frameworks.