Introduction: Cephalometric analysis is essential in orthodontic treatment, and it is progressing toward auto-matic cephalometric analysis. This study aimed to establish a cephalometric landmark detection model on the basis of a high-resolution net and improve the accuracy with high resolution. Methods: A total of 2000 lateral cephalograms were collected to construct a dataset, and the number of target landmarks was 51. A high-resolution network model was applied to the landmark detection task. Four models were trained by adjusting different input resolutions to choose the most suitable resolution. A test set consisting of 300 lateral cephalograms was used for evaluation. The model was evaluated from the error size and distribution of each landmark. Results: After 200 epochs of training, a landmark detection model was established. Under different resolutions of the input image, the mean model radial error decreased initially and then increased. At 680 3 920 pixels resolution, the minimum error and the highest detection success rate were obtained. The mean radial error was 1.08 6 0.87 mm. The detection success rates of 2.0 mm, 2.5 mm, 3.0 mm, and 4.0 mm were 89.00%, 94.00%, 96.33%, and 98.67%, respectively. The mean radial errors of 22 landmarks were <1 mm, and the errors of other landmarks were <2 mm except for the pterion. The error distribution of landmarks followed a certain pattern. Conclusions: An automatic landmark detection model based on a high-resolution net was established to recognize 51 landmarks. The model showed high detection accuracy, which provides a basis for further measurement application. (Am J Orthod Dentofacial Orthop 2023;163:501-8)