Objective　To investigate clinical value of individual three-dimensional digital manikin (3D-DM) on the transnasal endoscopic approach to petrous bone.　Methods　Ten adult cadaveric heads (20 sides) fixed with formalin were dyed through the artery with silicone rubber (RTV3110) and 12.5% Iopromide. Then specimens were scanned by 320-detector-row spiral CT with coronal, axial and sagittal positions. The images were stored in DICOM format, imported into 3D view software and reconstructed individual 3D-DM，on which the technology of "reverse bone window formed" were used to design and simulate the bone window formation of petrous bone. The anatomic marks of skull base related to the transnasal endoscopic approach to petrous bone in individual 3D-DM were observed and the distances between the related anatomic marks were measured. The endoscopic images were recorded, and the relationships of the surgical marks were observed and measured. Finally，The consistency between anatomy and 3D-DM data were explored.　Results　Individual 3D-DM of the samples was well reconstructed. The vision of individual 3D-DM was similar to that of endoscopic anatomy, as well the correlated parameters.　Conclusions　Individual 3D-DM can be used to simulate bone window formation of petrous bone preoperatively, which can improve the accuracy and security of the surgery. Individual 3D-DM can provide detailed information of bony structures, arteries supply and approach-related critical anatomical data, which had important clinical significance for transnasal endoscopic approach to petrous bone.