Vertical root fracture (VRF) is defined as a root fracture in the longitudinal direction, extending from the root to the crown on facial or lingual surfaces. Most VRFs occur in endodontically treated teeth, and the symptoms are similar to those of chronic apical periodontitis or chronic periodontitis. Diagnosing VRF with periapical radiography is difficult. Conversely, cone beam computed tomography (CBCT) provides three-dimensional images and is better at diagnosing VRF than periapical radiography. Therefore, dentists should know how to operate CBCT to obtain clear images and reduce image artifact interferences, thus achieving higher diagnostic accuracy. CBCT imaging includes acquisition configuration, image detection, image reconstruction, and image display. We retrospectively examined four human studies and 19 in vitro studies and focused on certain imaging parameters: field of view selection, voxel size, proper detectors, different image processing methods, and the influence of posts on clear image acquisition. Finally, we discuss the experimental design faults in the reviewed in vitro studies and suggest improvements for future CBCT techniques to achieve higher VRF diagnostic accuracy.