ABSTRACT Introduction Penile imaging for Peyronie's disease (PD) can be challenging. Traditional cross-sectional imaging modalities such as computerized tomography (CT) or magnetic resonance imaging (MRI) can delineate and characterize pathological penile anomalies; however, limitation in imaging interpretations do exist. Optimal imaging of the penis aids in surgical planning and patient counseling. Objective In this study, we aim to utilize a novel three-dimensional (3D) MRI fusion penile imaging modality for men undergoing surgical reconstruction for PD. Methods Men with PD, palpable plaques, and deformed corpora were included in this study. We obtained preoperative cross-sectional MRI penile images and Sexual Health Inventory for Men Questionnaire (SHIM) scores on all included patients. We fused MRI images with Ceevra (Ceevra, Inc., San Francisco, CA, USA) 3D imaging software to develop detailed imaging aiding surgical reconstruction. 3D models were used for preoperative patient counseling and surgical planning as well as intraoperatively. Results A total of six patients were included, 3 African American men and 3 White men. The mean age was 65 and mean BMI was 35. There was no difference in preoperative SHIM scores (4 severe and 2 mild erectile dysfunction). Preoperative MRI images were fused with Ceevra software to develop detailed 3D models of corporal plaques and its related structures. The 3D models were easily accessible to surgeons during preoperative clinic visits and at time of reconstruction (Figure 1). Conclusions In this study, 3D MRI fusion penile imaging for PD has emerged as a potential preoperative advanced imaging modality useful for preoperative counseling and planning, especially in complex PD cases. Further evaluation is prerequisite to evaluate its potential role in aiding intraoperative decision making. Disclosure No