A three dimensional image processing apparatus includes a storage unit storing data of images in different radiographing directions together with information concerning cardiac phases, a key image selection unit selecting key images from the images, a feature point designation unit designatting feature points on the selected key images in accordance with operation by an operator, and an image reconstruction unit reconstructing a three dimensional image from the images on the basis of positions of the designated feature points, wherein the key image selection unit selects, as the key images, a pair of images which are located at the same cardiac phase and whose radiographing directions are different by a substantially predetermined angle and images spaced apart from each other by an angle obtained by substantially equally dividing an interval between the pair of images by a predetermined number.