We have developed an automated segmentation method for three-dimensional vascular ultrasound images. The method consists of two steps: an automated initial contour identification, followed by application of a geometrically deformable model (GDM). The formation of the initial contours requires the input of a single seed point by the user, and was shown to be insensitive to the placement of the seed within a structure. The GDM minimizes contour energy, providing a smoothed final result. It requires only three simple parameters, all with easily selectable values. The algorithm is fast, performing segmentation on a 336×352×200 volume in 25 s when running on a 100 MHz 9500 Power Macintosh prototype. The segmentation algorithm was tested on stenosed vessel phantoms with known geometry, and the segmentation of the cross-sectional areas was found to be within 3% of the true area. The algorithm was also applied to two sets of patient carotid images, one acquired with a mechanical scanner and the other with a freehand scanning system, with good results on both.