A new, practical, and efficient approach is proposed for 3D vascular segmentation and bifurcation structure extraction. The method uses a combination of mathematical morphology, region-growing schemes, and shape features in addition to greyscale information. By an extension of math-morphological operations within bounded space of vascular shape, smooth and natural region-growing and sensitivity-controllable bifurcation detection were realized. The algorithm was implemented in the interactive segmentation and visualization software package VOXELMAN and validated with clinical data of X-ray CT angiography and MRA.