Background Knowledge of the anatomy of the facial vein is essential for plastic surgery and filler injection. Objectives The authors sought to investigate the variation and 3-dimensional (3D) course of the facial vein utilizing computed tomographic angiography. Methods The computed tomographic angiography images of 300 facial veins from 150 Asian patients were included in this study. The distance between each anatomical landmark and the facial vein was measured to position the course. The depth of the facial vein beneath the skin and the height of the facial vein above the periosteum were measured at 5 anatomical planes. Results The facial vein showed a relatively constant course with a frequency of 7.0% variation. The vertical distance between the medial canthus, midpoint of inferior orbital rim, or external canthus and the facial vein was 10.28 2.17 mm, 6.86 +/- 2.02 mm, or 48.82 +/- 7.26 mm, respectively. The horizontal distance between medial canthus, nasal alar, or oral commissure and the facial vein was 6.04 +/- 1.44 mm, 22.34 +/- 3.79 mm, or 32.21 +/- 4.84 mm, respectively. The distance between the mandibular angle or oral commissure and the facial vein at the inferior of mandible was 24.99 +/- 6.23 mm or 53.04 +/- 6.56 mm. The depth of the facial vein beneath the skin and the height of the facial vein above the periosteum varied from the plane of the medial canthus to the plane of the mandible. Conclusions This study revealed the 3D course of the facial vein with reference to anatomical landmarks. Detailed findings of the facial vein will provide a valuable reference for plastic surgery and filler injection.