A stereo-photogrammetric method for three-dimensional reconstruction of points in low-dose digital X-ray images obtained using a scanner with similar imaging geometry to that of computed tomography scan projection radiography, was analysed. A calibration frame containing 25 radio-opaque markers with known three-dimensional locations was scanned, and the accuracy of reconstruction of the marker positions under varying control point configurations and separation angles was assessed. Errors of less than 1 mm were obtained when nine test points were reconstructed, with 16, 11 and 7 control points at a 90 degrees separation angle, and with 16 and 11 control points at 75 degrees and 60 degrees separation angles. The optimum reconstruction, with a resultant error of 0.68 mm, was found to occur at a separation angle of 90 degrees, with the largest number of control points (16) used to calculate the parameters of the transformation. Extrapolation in the scanning direction beyond the space defined by the control points gave errors of less than 2 mm. This method should be suitable for three-dimensional point reconstruction in applications such as cephalometry, brachytherapy planning and assessment of spinal shape.