OBJECTIVES: To assess the appearance, location, and course of the incisive canal as compared to other anatomical landmarks on spiral CT of the mandible. METHODS: Study material included 230 spiral CT scans taken for preoperative planning of implant placement in the posterior mandible. All scanning was performed using a standard exposure and patient positioning protocol. Axial, panoramic, and reformatted cross-sectional images were carefully examined. Visibility of the incisive canal and other anatomical landmarks was scored using a four-point rating scale. The vertical and buccolingual diameter of the outer contour as well the diameter of the inner contour of the incisive canal were measured using a digital sliding caliper. RESULTS: An incisive canal was identified in 93% of the cases, with good visibility in 22% of the cases. Mean (s.d.) vertical diameter, buccolingual diameter, and inner diameter of the incisive canal were 4.7 (1.1), 3.7 (0.7), and 1.1 (0.3) mm respectively. The mandibular canal, mental foramen, lingual foramen, and anterior looping appeared in 98, 100, 82 and 7% of the images respectively. CONCLUSIONS: A well-defined incisive canal could be detected in the majority of spiral CT scans. Its radiographic detection remained lower than for the mandibular canal or mental foramen, but higher than for the visibility of the lingual foramen. Visualisation of the incisive canal and the occasional presence of an anterior looping, demonstrates the potential value of cross-sectional imaging of the anterior mandible for presurgical planning purposes.