Systems and methods for orthognathic surgical planning are described herein. An example computer-implemented method can include generating a composite three-dimensional (3D) model of a subject's skull, defining a primal reference frame for the composite 3D model, performing a cephalometric analysis on the composite 3D model to quantify at least one geometric property of the subject's skull, performing a virtual osteotomy to separate the composite 3D model into a plurality of segments, performing a surgical simulation using the osteotomized segments, and designing a surgical splint or template for the subject.