Introduction: With the increase use of CBCT scans in orthodontic diagnosis and treatment planning. It could be prudent to validate the use of radiographic images obtained from CBCT instead of multiple conventional radiographs. Hence, the present study was designed to assess whether a difference exists between cephalometric measurements based on manual tracings (MT), digitized lateral cephalograms (DLC) and in lateral cephalograms generated from CBCT scans. Materials and Methods: Conventional lateral cephalograms and cone beam computed tomography (CBCT) scans from ten subjects from departmental archives were selected to test the three methods: manual tracings, digitized lateral cephalograms, and lateral cephalograms derived from CBCT. 17 measurements were evaluated and retraced after a 7-day period. The intra examiner errors was assessed using paired T test and Dahlberg formula. The pearson correlation test and ANOVA tests were used to compare the differences between the methods. Results: Most of the measurements had intra-examiner reliability in all three methods. Eight measurements were statistically different between the methods. Conclusion: All three methods proved to be reliable and reproducible with minimum error in measurement of lateral cephalogram derived from CBCT. CBCT scan advised for complex cases can be used to generate lateral cephalogram image, which may reduce the need for multiple radiographs; thereby reducing the radiation exposure and cost.