Abstract. During prostate brachytherapy, C-arm flouroscopy images are used for a qualitative assessment of the procedure. Three dimensional reconstruction of the implanted seeds can be used for intraoperative dosimetry and quantitative assessment. Accurate C-arm pose estimation is necessary for 3D localization of the seeds. We propose to measure the C-arm rotation angles and computationally compensate the inevitable C-arm translational motion to estimate the pose. We compensate the oscillation, sagging and wheel motion of the C-arm using a three-level optimization algorithm, without which the reconstruction can fail. We validated our approach on simulated and 10 data sets from 5 patients and gained on average 99.1% success rate, 0.33 mm projection error and computation time of less than one minute per patient, which are clinically excellent results.