By adding perspective information in addition to binocular parallax, the invention provides a three-dimensional medical imaging apparatus that allows surgery to be performed with a more natural three-dimensional view, similar to that achieved with the naked eye. The three-dimensional medical imaging apparatus includes an image-acquisition optical system and an imaging device for acquiring three-dimensional images of a subject. The image-acquisition optical system includes an objective optical system for forming an image of the subject at an image-forming plane, and an entrance pupil position of the image-acquisition optical system is disposed between the objective optical system and the subject.