A 3D model-based approach for quantification of vascular morphology from several MRA acquisition protocols was evaluated. Accuracy, reproducibility, and influence of the image acquisition techniques were studied via in vitro experiments with ground truth diameters and the measurements of two expert readers as reference. The performance of the method was similar to or more accurate than the manual assessments and reproducibility was also improved. The methodology was applied to stenosis grading of carotid arteries from CE MRA data. In 11 patients, the approach was compared to manual scores (NASCET criterion) on CE MRA and DSA images, with the result that the model-based technique correlates better with DSA than the manual scores. Spearman's correlation coefficient was 0.91 (P < 0.001) for the model-based technique and DSA vs. 0.80 and 0.84 (P < 0.001) between the manual scores and DSA. From the results it can be concluded that the approach is a promising objective technique to assess geometrical vascular parameters, including degree of stenosis. Magn Reson Med 45:311-322, 2001.