Will the advent of the cartographic digitizer result in two standards of cephalometric investigation—first class, computer-based, with results of a high level of credibility and second class, traditional methods of doubtful acceptability? On 50 lateral skull radiographs (25 male and 25 female) from Belfast material, 14 cephalometric points were determined on the digitizer in the Orthodontic Department of Oslo Dental School. Using the same axes, the coordinates of the same points were then determined in the traditional way by direct measurement. Double determinations were made for each method and the discrepancies were compared. For the horizontal coordinates, the mean digitizer discrepancies were smaller than those of the traditional methods in 12 of the 14 points but, in comparing the standard deviations, the digitizer was superior in only 9 of the 14. For the vertical coordinates the mean discrepancy of digitizer measurements was smaller in 12 of the 14 points but the standard deviation was smaller in only 8 instances. The study showed that the traditional methods were inferior to those obtained by the digitizer but not alarmingly so, and in some cases the traditional methods produced more accurate results. Two advantages of the digitizer were that for points on a curved outline having such terms as the ‘most anterior’, ‘most posterior’, ‘highest’ or ‘lowest’ as part of their definition the digitizer can be used to find the point in addition to digitizing it. The digitizer also offers advantages in terms of speed and of preparation of data for computer analysis. However, for growth analysis or clinical applicability, many areas of bones do not have anatomical features that can be located with a degree of precision that matches that of the digitizer.